中国感染控制杂志2026，Vol.25Issue(3)：344-351,8.DOI:10.12138/j.issn.1671-9638.20262960
ICU三级感染防控管理多重耐药菌防控效果:一项前瞻性研究
Effect of three-tier infection prevention and control management on the prevention and control of multidrug-resistant organism in intensive care unit:a prospective study
摘要
Abstract
Objective To explore the solution strategies for the"difficult implementation"of drug-resistant orga-nism prevention and control measures in intensive care unit(ICU),and evaluate the effectiveness.Methods Patients admitted to the ICU of a tertiary first-class hospital from April 2022 to February 2024 were selected as the research subjects.The prospective,before and after comparison design was adopted,April 2022 to June 2023 and July 2023 to February 2024 were as the control stage and intervention stage,respectively.The control group implemented bundled prevention and control measures and routine management,the intervention group established a three-tier healthcare-associated infection(HAI)management structure(department internal management-section/group-em-ployee)on the basis of implementing measures of control group,the implementation of various infection control measures was promoted.The 1∶1 propensity score matching(PSM)was used to evaluate the incidence of HAI and colonization rate of carbapenem-resistant organism(CRO)before and after intervention.Results The intervention group used 6.10 and 7.26 times more alcohol-based hand rub and hand sanitizers,7.18 and 5.69 times more chlorine-containing disinfectant effervescent tablets and disinfectant wipes,as well as 2.76 times more isolation gowns respectively than the control group,the isolation order issuance rate increased from 62.89%to 89.27%,differences were all statistically significant(all P<0.001).Before PSM,the risk of acquiring CRO,carbapenem-resistant Acinetobacter baumannii(CRAB),and carbapenem-resistant Klebsiella pneumoniae(CRKP)in intervention group was 0.61,0.67,and 0.80 times that of before intervention,respectively,except for CRKP(P=0.245),others were all with statistically significant differences(all P<0.05);After PSM,the risk of acquiring CRO,CRAB,and CRKP in the intervention group was 0.97,0.92,and 0.97 times that of before intervention,respectively,all were with statistically significant differences(all P<0.05).Conclusion After implementing the three-tier management on infection prevention and control in department,the implementation of ICU isolation measures has significantly improved,and the incidences of CRO HAI and colonization have decreased.关键词
碳青霉烯类耐药菌/倾向性评分匹配/预防与控制/效果评价/重症监护病房/前瞻性研究Key words
carbapenem-resistant organism/propensity score matching/prevention and control/effect evaluation/intensive care unit/prospective study分类
医药卫生引用本文复制引用
裴小琴,马轶,梁子超,刘颖,周昕玥,聂睿彤,马萍,张元川..ICU三级感染防控管理多重耐药菌防控效果:一项前瞻性研究[J].中国感染控制杂志,2026,25(3):344-351,8.基金项目
四川省科技厅重点研发项目(2023YFS0115) （2023YFS0115）
