3年MRSA医院感染预防控制行动效果

摘要

目的 调查某院耐甲氧西林金黄色葡萄球菌(MRSA)医院感染获得情况,了解医院感染控制措施的成效.方法 采取一系列感染控制综合措施,同时分析2008-2010年每千住院日MRSA医院感染发病率和每住院日手卫生用品用量,比较两者关系.结果 该院MRSA千住院日医院感染获得率,2008年为0.41‰,2009年为0.30‰,2010年为0.27‰,3年逐年下降,差异有统计学意义(x2=18.918,P=0.000)；每住院日手卫生用品用量呈逐年上升趋势(11.36～27.41mL/住院日),但差异无统计学意义(F=0.108,P=0.750);每千住院日MRSA医院感染获得率和每住院日手卫生用品用量之间无相关关系(F=0.022,P=0.886).重症监护室(ICU) MRSA千住院日医院感染获得率,2008年为2.13‰,2009年为1.99‰,2010年为2.20‰,3年差异无统计学意义(x2=0.178,P=0.915).结论 该院MRSA千住院日医院感染获得率逐年下降并非是手卫生用品用量增加单一因素的结果,而是综合感染控制措施的成效；ICU感染控制措施有一定成效,但并不乐观,ICU MRSA以及其他耐药菌的预防与控制仍是工作重点.%Objective To survey the data of healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) infection in a hospital, and evaluate the impact of the reinforcement of infection control. Methods A series of comprehensive infection control measures were undertaken, the incidence of HA-MRSA infection /1 000 patient-days and the amount of hand hygiene product consumption/patient- day from 2008 to 2010 were analyzed and compared. Results The incidence of HA-MRSA infection/1 000 patient-days in this hospital was 0. 41%0, 0. 30%0, and 0. 27%0 in 2008, 2009 and 2010 respectively (χ2 = 18. 918,P= 0. 000); the amount of hand hygiene product consumption / patient-day increased each year (11. 36-27. 41 mL/patient day) (F=0.108, P = 0. 750)(there was no significant correlation between incidence of HA-MRSA infection/1 000 patient-days and the amount of hand hygiene product consumption/patient-day (F = 0. 022,P = 0. 886). The incidence of HA-MRSA infection/1 000 patient-days in intensive care unit was 2. 13 %o, 1. 99%0 and 2. 20%0 in 2008, 2009, and 2010 respectively. Conclusion The decreasing trend of the incidence of HA-MRSA infection/1 000 patient-days( χ2 =0. 178, P = 0. 915) emphasizes the effectiveness of the reinforcement of comprehensive infection control programme.