基于荧光标记法的集束化措施在多重耐药菌感染预防与控制中的效果

The effectiveness of fluorescence labeling-based assay bundle intervention in the prevention and control of multidrug-resistant organism infection

摘要:

目的 采取基于荧光标记法的集束化防控措施, 观察多重耐药菌(MDRO)感染预防与控制的效果。 方法 选取某院2022年1—12月检出MDRO的患者为研究对象。收集MDRO监测数据及防控措施落实情况。采用荧光标记法监测床单元环境物体表面的清洁消毒效果, 干预后组在对干预前组采取集束化防控措施与管理模式的基础上, 针对干预前组发现的问题实施强化整改措施。比较2022年1—6月(干预前)与2022年7—12月(干预后)相关指标变化。 结果 干预前组共有136例MDRO感染患者, 检出MDRO 208株, 发生医院感染10例。干预后组共有128例MDRO感染患者, 检出MDRO 198株, 发生医院感染9例。干预后患者耐甲氧西林金黄色葡萄球菌(MRSA)、耐碳青霉烯类鲍曼不动杆菌(CRAB)及MDRO总检出率较干预前均有所降低(均P＜0.05)。干预后环境物体表面MRSA、耐碳青霉烯类铜绿假单胞菌(CRPA)、CRAB及MDRO总检出率均低于干预前(均P＜0.05)。干预前环境物体表面MDRO检出率为34.52%, 干预后环境物体表面MDRO检出率呈下降趋势(P＜0.05)。干预前荧光标记位点清除率为41.84%;实施干预措施后, 7—12月荧光标记点清除率呈上升趋势, 在干预末(11—12月)达85.00%。干预后隔离医嘱下达、隔离标识放置、医疗用品专用、医疗废物正确处置的依从率均较干预前提高(均P＜0.05)。 结论 采取基于荧光标记法的集束化防控措施可有效提高MDRO感染预防与控制效果。

Abstract:

Objective To observe the effectiveness of fluorescence labeling-based assay bundle intervention in the prevention and control of multidrug-resistant organism (MDRO) infection. Methods Patients who were detected MDRO in a hospital from January to December 2022 were selected as the research subjects. MDRO monitoring data and implementation status of prevention and control measures were collected. Fluorescence labeling assay was adopted to monitor the cleaning and disinfection effectiveness of the surrounding object surface of the bed units. Based on the bundled prevention and control measures as well as management mode of the pre-intervention group, the post-intervention group implemented enhanced rectification measures for the problems found by the pre-intervention group. Changes in relevant indicators between January-June 2022 (before intervention) and July-December 2022 (after intervention) were compared. Results There were 136 MDRO-infected patients in the pre-intervention group, 208 MDRO strains were detected and 10 healthcare-associated infection (HAI) occurred. There were 128 MDRO-infected patients in the post-intervention group, 198 MDRO strains were detected and 9 HAI occurred. After intervention, the total detection rates of methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter baumannii (CRAB), and total MDRO from patients decreased significantly compared to before intervention (all P < 0.05). After intervention, the detection rates of MRSA, carbapenem-resistant Pseudomonas aeruginosa (CRPA), CRAB, and total MDRO from the surrounding object surface were all lower than those before intervention (all P < 0.05). The detection rate of MDRO from surrounding object surface before intervention was 34.52%, which showed a decreased trend after intervention (P < 0.05). The clearance rate of fluorescent labeled markers before intervention was 41.84%, which showed an upward trend after implementing intervention measures (from July to December), and increased to 85.00% at the end of intervention (November-December). The comp-liance rates of issuing isolation medical orders, placing isolation labels, using medical supplies exclusively, and correctly handling medical waste after intervention have all increased compared to before intervention (all P < 0.05). Conclusion Adopting fluorescence labeling-based assay bundle intervention can effectively improve the effectiveness of MDRO infection prevention and control.