Effect of different interventions on the control of multidrug-resistant organisms in primary general hospitals_West China Medical Journal

Authors：

 HE Li ¹ , LÜ Yu ² , XU Liping ¹ , LAI Changzheng ¹

1. Nosocomial Infection Management Department, People’s Hospital of Pujiang County, Pujiang, Sichuan 611630, P. R. China;
2. Nosocomial Infection Management Office, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding author：

HE Li, Email: 11053391@qq.com

Keywords：

Multidrug-resistant organism; Intervention; Nosocomial infection; Hand hygiene

DOI：

10.7507/1002-0179.201701045

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To know the status quo of multidrug-resistant organism (MDRO) infection in primary general hospitals, analyze the differences among various intervention measures, and put forward guiding principles for MDRO infection control in primary general hospitals. Methods We investigated all patients (n=51 612) admitted into the hospital between January 2013 and December 2015, and found out 6 types of MDRO. Pre-interventional investigation was carried out between January 2013 and June 2014 (before intervention) during which no intervention measures were taken; Intervention was carried out between July 2014 and December 2015 (after intervention). All departments in the hospital (6 groups) were matched with intervention measures (6 groups) randomly. Then, we compared the MDRO detection rate, nosocomial infection case rate and intervention compliance rate among the groups. Results We detected altogether 611 MDRO cases (without duplication) out of the 51 612 cases. The total detection rate of MDRO was 1.18%. The detection rate of MDRO before and after intervention was 1.37% and 1.01%, respectively. The difference between the two was of statistical significance (P<0.05). After the intervention, the detection rate in groups 1, 5 and 6 was significantly lower than before (P<0.05); the differences in detection rate among groups 2, 3, and 4 were not significant (P> 0.05). Nosocomial infection rate decreased from 0.28% before intervention to 0.14% after intervention (P<0.05). After the intervention, MDRO nosocomial infection case rate of groups 1, 5 and 6 was significantly lower than before (P<0.05); the rate was lower in groups 3 and 4 than before without any significance (P>0.05); no MDRO cases were detected in group 2 and comparison was meaningless. The knowledge rates of medical workers and of nursing staff increased from 52.97% and 20.00% before intervention to 78.76% and 66.34% after intervention, respectively (χ²=30.670, 38.604;P<0.05). The compliance to all kinds of protection measures improved significantly (P<0.05) except compliances to equipment of hand antiseptic agent and patient transfer order (P> 0.05). Conclusion Promoting the compliance rate to hand hygiene and environmental cleaning and disinfection, primary general hospitals can decrease the detection rate and nosocomial infection case rate of MDRO.

Citation： HE Li, LÜ Yu, XU Liping, LAI Changzheng. Effect of different interventions on the control of multidrug-resistant organisms in primary general hospitals. West China Medical Journal, 2017, 32(3): 329-333. doi: 10.7507/1002-0179.201701045 Copy

1.	胡必杰, 宗志勇, 顾克菊. 多重耐药菌感染控制最佳实践. 上海: 上海科学技术出版社, 2012: 1-33.
2.	中华人民共和国国家卫生和计划生育委员会. 卫生部办公厅关于加强多重耐药菌医院感染控制工作的通知. (2008-07-15)[2014-01-01]. .
3.	Magiorakos AP, Srinivasan A, Carey RB,et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect, 2012, 18(3): 268-281.
4.	中华人民共和国卫生部. WS/T 313－2009 医务人员手卫生规范, 2009.
5.	李春辉. MDR、XDR、PDR多重耐药菌暂行标准定义——国际专家建议. 中国感染控制杂志, 2014, 13(1): 62-64.
6.	中华人民共和国国家卫生和计划生育委员会. 卫生部办公厅关于印发《多重耐药菌医院感染预防与控制技术指南(试行)》的通知. (2011-01-06)[2014-01-01]. .
7.	中华人民共和国卫生部. 医院感染诊断标准(试用) 中华医学杂志, 2001, 81(5): 314.
8.	胡付品, 朱德妹, 汪复, 等. 2014 年 CHINET 中国细菌耐药性监测. 中国感染与化疗杂志, 2015, 15(5): 401-410.
9.	Eckmanns T, Bessert J, Behnke M,et al. Compliance with antiseptic hand rub use in intensive care units: the hawthorne effect. Infect Control Hosp Epidemiol, 2006, 27(9): 931-934.
10.	Kohli E, Ptak J, Smith R,et al. Variability in the hawthorne effect with regard to hand hygiene performance in high- and low-performing inpatient care units. Infect Control Hosp Epidemiol, 2009, 30(3): 222-225.
11.	吴淑梅, 黄小兰, 任泽娟. 集束化管理策略在多重耐药菌管理中的应用. 中国感染控制杂志, 2015, 14(12): 840-842, 845.
12.	刘彩红, 李福琴, 刘盛楠, 等. 综合干预措施可降低重症监护病房多重耐药菌医院感染发病率. 中国感染控制杂志, 2015, 14(8): 553-556.
13.	雷曦兵, 陈丽萍, 肖亚雄, 等. 某三级甲等实施多重耐药菌防控干预效果研究. 华西医学, 2016, 31(3): 409-413.
14.	黄勋, 邓子德, 倪语星, 等. 多重耐药菌医院感染预防与控制中国专家共识. 中国感染控制杂志, 2015, 14(1): 1-9.
15.	冯燕, 田永明, 蔡琳. 重症医学科加强预防多重耐药菌患者的护理干预前后对比. 华西医学, 2016, 31(7): 1277-1281.

1. 胡必杰, 宗志勇, 顾克菊. 多重耐药菌感染控制最佳实践. 上海: 上海科学技术出版社, 2012: 1-33.
2. 中华人民共和国国家卫生和计划生育委员会. 卫生部办公厅关于加强多重耐药菌医院感染控制工作的通知. (2008-07-15)[2014-01-01]. .
3. Magiorakos AP, Srinivasan A, Carey RB,et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect, 2012, 18(3): 268-281.
4. 中华人民共和国卫生部. WS/T 313－2009 医务人员手卫生规范, 2009.
5. 李春辉. MDR、XDR、PDR多重耐药菌暂行标准定义——国际专家建议. 中国感染控制杂志, 2014, 13(1): 62-64.
6. 中华人民共和国国家卫生和计划生育委员会. 卫生部办公厅关于印发《多重耐药菌医院感染预防与控制技术指南(试行)》的通知. (2011-01-06)[2014-01-01]. .
7. 中华人民共和国卫生部. 医院感染诊断标准(试用) 中华医学杂志, 2001, 81(5): 314.
8. 胡付品, 朱德妹, 汪复, 等. 2014 年 CHINET 中国细菌耐药性监测. 中国感染与化疗杂志, 2015, 15(5): 401-410.
9. Eckmanns T, Bessert J, Behnke M,et al. Compliance with antiseptic hand rub use in intensive care units: the hawthorne effect. Infect Control Hosp Epidemiol, 2006, 27(9): 931-934.
10. Kohli E, Ptak J, Smith R,et al. Variability in the hawthorne effect with regard to hand hygiene performance in high- and low-performing inpatient care units. Infect Control Hosp Epidemiol, 2009, 30(3): 222-225.
11. 吴淑梅, 黄小兰, 任泽娟. 集束化管理策略在多重耐药菌管理中的应用. 中国感染控制杂志, 2015, 14(12): 840-842, 845.
12. 刘彩红, 李福琴, 刘盛楠, 等. 综合干预措施可降低重症监护病房多重耐药菌医院感染发病率. 中国感染控制杂志, 2015, 14(8): 553-556.
13. 雷曦兵, 陈丽萍, 肖亚雄, 等. 某三级甲等实施多重耐药菌防控干预效果研究. 华西医学, 2016, 31(3): 409-413.
14. 黄勋, 邓子德, 倪语星, 等. 多重耐药菌医院感染预防与控制中国专家共识. 中国感染控制杂志, 2015, 14(1): 1-9.
15. 冯燕, 田永明, 蔡琳. 重症医学科加强预防多重耐药菌患者的护理干预前后对比. 华西医学, 2016, 31(7): 1277-1281.

West China Medical Journal

Effect of different interventions on the control of multidrug-resistant organisms in primary general hospitals

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content