抗生素管理及手卫生对新生儿耐碳青霉烯类肠杆菌科细菌感染的影响

摘要

Objective To investigate the effect of standardized usage of antibiotics and hand hygiene on carbapenem-re-sistant Enterobacteriaceae (CRE) infection in neonates. Methods According to the situation of standardized management of an-tibiotics in our hospital, the study period, from January 2011 to December 2013, was divided into pre-intervention, transition and post-intervention. Retrospective study was employed to analyze the antibiotics use density (AUD), the hand hygiene compliance rate among the medical staff, the positive rate of CRE and the nosocomial infection percentage of the neonatology department. Results From pre-intervention to post-intervention period, the AUD was decreased from 12.93 DDDs to 8.10 DDDs;hand hy-giene compliance rate of medical staff was increased from 53.49%to 83.33%;the detection rate of CRE was decreased from 3.71%to 2.27%. The differences were all signiifcant among different periods (P<0.01). The nosocomial infection percentage decreased from 0.22%to 0.17%and there was no signiifcant difference (P=0.441). Conclusions Standardized usage of antibiotics and hand hygiene can be served as economical yet effective approaches to controlling CRE infection in neonates.%目的：探讨抗生素和手卫生规范管理对防控新生儿碳青霉烯类耐药肠杆菌科细菌(CRE)感染的意义。方法根据医院抗菌药物专项整治情况，将2011年1月至2013年12月划分为整治前期、过渡期以及整治后期，对同期新生儿病房抗生素使用强度、医务人员手卫生依从率、CRE检出率以及院内感染百分率等指标进行回顾性分析。结果抗生素使用强度从12.93 DDDs降至8.10 DDDs，医务人员手卫生依从率从53.49%升至83.33%，肠杆菌科细菌CRE检出率由3.71%降至2.27%，差异有统计学意义(P均<0.01)；院内CRE感染率由0.22%降至0.17%，但未达统计学意义(P=0.441)。结论合理应用抗生素、推行手卫生可作为经济有效的新生儿CRE感染防治措施。