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

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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

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11.	吳淑梅, 黃小蘭, 任澤娟. 集束化管理策略在多重耐藥菌管理中的應用. 中國感染控制雜志, 2015, 14(12): 840-842, 845.
12.	劉彩紅, 李福琴, 劉盛楠, 等. 綜合干預措施可降低重癥監護病房多重耐藥菌醫院感染發病率. 中國感染控制雜志, 2015, 14(8): 553-556.
13.	雷曦兵, 陳麗萍, 肖亞雄, 等. 某三級甲等實施多重耐藥菌防控干預效果研究. 華西醫學, 2016, 31(3): 409-413.
14.	黃勛, 鄧子德, 倪語星, 等. 多重耐藥菌醫院感染預防與控制中國專家共識. 中國感染控制雜志, 2015, 14(1): 1-9.
15.	馮燕, 田永明, 蔡琳. 重癥醫學科加強預防多重耐藥菌患者的護理干預前后對比. 華西醫學, 2016, 31(7): 1277-1281.

1. ?胡必杰, 宗志勇, 顧克菊. 多重耐藥菌感染控制最佳實踐. 上海: 上海科學技術出版社, 2012: 1-33.
2. 中華人民共和國國家衛生和計劃生育委員會. 衛生部辦公廳關于加強多重耐藥菌醫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. 中華人民共和國衛生部. WS/T 313－2009 醫務人員手衛生規范, 2009.
5. 李春輝. MDR、XDR、PDR多重耐藥菌暫行標準定義——國際專家建議. 中國感染控制雜志, 2014, 13(1): 62-64.
6. 中華人民共和國國家衛生和計劃生育委員會. 衛生部辦公廳關于印發《多重耐藥菌醫院感染預防與控制技術指南(試行)》的通知. (2011-01-06)[2014-01-01]. .
7. 中華人民共和國衛生部. 醫院感染診斷標準(試用) 中華醫學雜志, 2001, 81(5): 314.
8. 胡付品, 朱德妹, 汪復, 等. 2014 年 CHINET 中國細菌耐藥性監測. 中國感染與化療雜志, 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. 吳淑梅, 黃小蘭, 任澤娟. 集束化管理策略在多重耐藥菌管理中的應用. 中國感染控制雜志, 2015, 14(12): 840-842, 845.
12. 劉彩紅, 李福琴, 劉盛楠, 等. 綜合干預措施可降低重癥監護病房多重耐藥菌醫院感染發病率. 中國感染控制雜志, 2015, 14(8): 553-556.
13. 雷曦兵, 陳麗萍, 肖亞雄, 等. 某三級甲等實施多重耐藥菌防控干預效果研究. 華西醫學, 2016, 31(3): 409-413.
14. 黃勛, 鄧子德, 倪語星, 等. 多重耐藥菌醫院感染預防與控制中國專家共識. 中國感染控制雜志, 2015, 14(1): 1-9.
15. 馮燕, 田永明, 蔡琳. 重癥醫學科加強預防多重耐藥菌患者的護理干預前后對比. 華西醫學, 2016, 31(7): 1277-1281.

West China Medical Journal

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

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