Effects of Active Intervention in Prevention and Control of Nosocomial Infection in ICU: A Non-concurrent Control Trial_Chinese Journal of Evidence-Based Medicine

Authors：

 ZENGXiu-yu , ZHANGHua-ping , CHENXia-rong , QIUXiu-lan , WENGYue-ping , LINLi-ling , WUYi-hai , LIUHua-ling

Department of Infection Control, the Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China;

Corresponding?author：

Keywords：

Multidrug-resistant organism; Active screening; Intensive care unit; Intensive intervention

DOI：

10.7507/1672-2531.20160099

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Objective To evaluate the effect of active screening and intervention of multidrug-resistant organisms (MDROs) on control nosocomial infection in the general intensive care unit (ICU). Methods A non-concurrent control trial was conducted in patients hospitalized in the ICU for more than 24 hours in the Second Affiliated Hospital of Fujian Medical University. Patients underwent active screening of MDROs for nasal vestibular swab, throat swab and rectal swab combined with further intensive intervention for patients with positive screening result during Sept. 2014 to Aug. 2015 were included as an intervention group, patients only underwent active screening during Sept. 2013 to Aug. 2014 were included as a screening group, and patients without undergoing active screening during Sept. 2012 to Aug. 2013 were as a control group. SPSS 19.0 software was used to compare the hospital infection rate and the infection rate of MDROs among the three groups. Results A total of 1?773 patients were included, of which 655 patients were in the intervention group, 515 patients were in the screening group, and 603 patients were in the control group. The difference of hospital infection rates among the three groups was statistically significant (χ²=21.087, P < 0.001), and further pairwise comparison results showed that the intervention group was lower than the screening group (χ²=5.891, P=0.015), and the screening group was lower than the control group (χ²=4.259, P=0.039). The adjustment daily infection rate of the intervention group, screening group and control group were 6.69‰, 10.88‰, and 15.39‰, respectively. The difference of MDROs hospital infection rates among the three groups was statistically significant (χ²=21.039, P < 0.001), and further pairwise comparison results showed that the intervention group was lower than the screening group (χ²=5.936, P=0.015), and the screening group was lower than the control group (χ²=5.798, P=0.016). The MDROs thousand daily infection rate of the intervention group was lower than that of the screening group (3.90‰ vs. 7.30‰, χ²=5.999, P=0.014). Conclusion The active screening plus intensive intervention of MDROs can effectively reduce the incidence rates of nosocomial infections and MDROs infections in ICU.

Citation： ZENGXiu-yu, ZHANGHua-ping, CHENXia-rong, QIUXiu-lan, WENGYue-ping, LINLi-ling, WUYi-hai, LIUHua-ling. Effects of Active Intervention in Prevention and Control of Nosocomial Infection in ICU: A Non-concurrent Control Trial. Chinese Journal of Evidence-Based Medicine, 2016, 16(6): 641-645. doi: 10.7507/1672-2531.20160099 Copy

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10.	唐紅萍, 高曉東, 樊春筍, 等. 主動篩查與組合干預對ICU多藥耐藥菌感染患者的效果評價. 中華醫院感染學雜志, 2015, (11): 2484-2486.
11.	許瑞寶, 葉麗娟. 預防多重耐藥菌感染暴發流行的護理探討. 中國實用醫藥, 2010, 5(26): 215-216.
12.	朱立紅, 沈元, 張申, 等. 醫務人員手衛生執行率與干預方法的調查. 中華醫院感染學雜志, 2008, 18(4): 542-544.
13.	游建萍, 黃慶, 府偉靈, 等. 手衛生所致醫院感染的預防和控制措施的探討. 中華醫院感染學雜志, 2005, 15(4): 426-428.
14.	周艷霞, 鐘元河, 尹云清, 等. 關于醫務人員手衛生質量管理調查報告. 中國消毒學雜志, 2007, 24(2): 165-167.
15.	王雪文, 顧克菊, 金珠, 等. ICU多重耐藥菌感染流行趨勢及控制措施. 護士進修雜志, 2008, 23(5): 411-412.
16.	Kollef MH. The intensive care unit as a research laboratory: developing strategies to prevent antimicrobial resistance. Surg Infect (Larchmt), 2006, 7(2): 85-99.
17.	Traa MX, Barboza L, Doron S, et al. Horizontal infection control strategy decreases methicillin-resistant Staphylococcus aureus infection and eliminates bacteremia in a surgical ICU without active surveillance. Crit Care Med, 2014, 42(10): 2151-2157.
18.	Osman MF, Askari R. Infection control in the intensive care unit. Surg Clin North Am, 2014, 94(6): 1175-1194.

1. ?汪復. 2006年中國CHINET細菌耐藥性監測. 中國感染與化療雜志, 2008, 8(1): 1-9.
2. 李建華, 張力燕, 王華, 等. 醫院獲得性耐藥菌感染分布特征及其規律性研究分析. 國際呼吸雜志, 2009, 29(10): 589-593.
3. 高偉, 鄭軍廷. 重癥監護病房病原菌流行菌株及其耐藥特點分析. 中華醫院感染學雜志, 2010, 20(21): 3414-3416.
4. 劉振華, 李彥, 賈淑琴, 等. 重癥監護病房病原菌分布與耐藥分析. 中華醫院感染學雜志, 2009, 19(22): 3116-3118.
5. 李六億, 劉玉樹. 醫院感染管理學. 北京: 人民衛生出版社, 2010: 27-276.
6. 富秀玉, 馬桂霞. 醫院多藥耐藥菌目標監測的調查與干預措施. 中華醫院感染學雜志, 2011, 21(8): 1615-1616.
7. Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev, 2010, 74(3): 417-433.
8. 崔紅, 姜振環, 李宏, 等. 醫務人員手衛生與醫院感染的管理對策. 中華醫院感染學雜志, 2010, 20(22): 3448.
9. 徐艷, 牟霞, 楊懷, 等. 組合干預對多藥耐藥菌感染預防控制的調查研究. 中華醫院感染學雜志, 2013, 23(20): 5048-5050.
10. 唐紅萍, 高曉東, 樊春筍, 等. 主動篩查與組合干預對ICU多藥耐藥菌感染患者的效果評價. 中華醫院感染學雜志, 2015, (11): 2484-2486.
11. 許瑞寶, 葉麗娟. 預防多重耐藥菌感染暴發流行的護理探討. 中國實用醫藥, 2010, 5(26): 215-216.
12. 朱立紅, 沈元, 張申, 等. 醫務人員手衛生執行率與干預方法的調查. 中華醫院感染學雜志, 2008, 18(4): 542-544.
13. 游建萍, 黃慶, 府偉靈, 等. 手衛生所致醫院感染的預防和控制措施的探討. 中華醫院感染學雜志, 2005, 15(4): 426-428.
14. 周艷霞, 鐘元河, 尹云清, 等. 關于醫務人員手衛生質量管理調查報告. 中國消毒學雜志, 2007, 24(2): 165-167.
15. 王雪文, 顧克菊, 金珠, 等. ICU多重耐藥菌感染流行趨勢及控制措施. 護士進修雜志, 2008, 23(5): 411-412.
16. Kollef MH. The intensive care unit as a research laboratory: developing strategies to prevent antimicrobial resistance. Surg Infect (Larchmt), 2006, 7(2): 85-99.
17. Traa MX, Barboza L, Doron S, et al. Horizontal infection control strategy decreases methicillin-resistant Staphylococcus aureus infection and eliminates bacteremia in a surgical ICU without active surveillance. Crit Care Med, 2014, 42(10): 2151-2157.
18. Osman MF, Askari R. Infection control in the intensive care unit. Surg Clin North Am, 2014, 94(6): 1175-1194.

Chinese Journal of Evidence-Based Medicine

Effects of Active Intervention in Prevention and Control of Nosocomial Infection in ICU: A Non-concurrent Control Trial

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