巴楚医学

目的：探讨主动筛查结合预先接触隔离干预模式在EICU多重耐药菌(MDRO)医院感染控制中的效果。方法：分析我院EICU行主动筛查结合预先接触隔离干预模式1年前后MDRO院内感染发生率、菌种分布、感染部位分布指标的情况，并对临床主动筛查的敏感度和特异度进行评价。结果：最终纳入1 787例患者，其中对照组869例，干预组918例。干预组院内MDRO感染发生率较对照组明显下降，差异具有统计学意义(P<0.05)。干预组MDRO菌种总体分布情况与对照组比较，无统计学差异(P>0.05);但干预组碳青霉烯类耐药肠杆科细菌(CRE)感染构成比高于对照组，差异具有统计学意义(P<0.05)。两组MDRO感染部位分布情况无统计学差异(P>0.05)。主动筛查MDRO的敏感度为88.57%,特异度为99.09%。主动筛查得出的检测结果与细菌学培养得出的结果，差异无统计学意义(P>0.05)。结论：主动筛查结合预先接触隔离干预模式能早期识别MDRO携带者，减少MDRO院内感染的发生。

Objective: To explore the effect of active screening combined with pre-contact isolation intervention mode on nosocomial multidrug resistant bacteria(MDRO) infection in EICU. Methods: The incidence of nosocomial MDRO infection, the distribution of strains and infected sites before and after 1 year of active screening combined with pre-exposure isolation intervention in the EICU of our hospital were analyzed. The sensitivity and specificity of clinical active screening were evaluated. Results: A total of 1 787 patients were finally included, including 869 patients in the control group and 918 patients in the intervention group. The incidence of nosocomial MDRO infection in the intervention group was significantly lower than that in the control group(P<0.05). There was no significant difference in the overall distribution of MDRO strains and infection sites between these two groups(both P>0.05). However, the composition ratio of carbapenem-resistant enterobacteriaceae(CRE) strains in the intervention group was higher than that in the control group, with statistically significant difference(P<0.05). The sensitivity of active screening of MDRO was 88.57%, and the specificity was 99.09%.There was no statistically significant difference between the test results obtained by active screening and the results obtained by bacteriological culture(P>0.05). Conclusion: Active screening combined with pre-contact isolation intervention can identify MDRO carriers early and reduce the incidence of nosocomial MDRO infection.