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

1.	汪复. 2006年中国CHINET细菌耐药性监测. 中国感染与化疗杂志, 2008, 8(1): 1-9.
2.	李建华, 张力燕, 王华, 等. 医院获得性耐药菌感染分布特征及其规律性研究分析. 国际呼吸杂志, 2009, 29(10): 589-593.
3.	高伟, 郑军廷. 重症监护病房病原菌流行菌株及其耐药特点分析. 中华医院感染学杂志, 2010, 20(21): 3414-3416.
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10.	唐红萍, 高晓东, 樊春笋, 等. 主动筛查与组合干预对ICU多药耐药菌感染患者的效果评价. 中华医院感染学杂志, 2015, (11): 2484-2486.
11.	许瑞宝, 叶丽娟. 预防多重耐药菌感染暴发流行的护理探讨. 中国实用医药, 2010, 5(26): 215-216.
12.	朱立红, 沈元, 张申, 等. 医务人员手卫生执行率与干预方法的调查. 中华医院感染学杂志, 2008, 18(4): 542-544.
13.	游建萍, 黄庆, 府伟灵, 等. 手卫生所致医院感染的预防和控制措施的探讨. 中华医院感染学杂志, 2005, 15(4): 426-428.
14.	周艳霞, 钟元河, 尹云清, 等. 关于医务人员手卫生质量管理调查报告. 中国消毒学杂志, 2007, 24(2): 165-167.
15.	王雪文, 顾克菊, 金珠, 等. ICU多重耐药菌感染流行趋势及控制措施. 护士进修杂志, 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. 汪复. 2006年中国CHINET细菌耐药性监测. 中国感染与化疗杂志, 2008, 8(1): 1-9.
2. 李建华, 张力燕, 王华, 等. 医院获得性耐药菌感染分布特征及其规律性研究分析. 国际呼吸杂志, 2009, 29(10): 589-593.
3. 高伟, 郑军廷. 重症监护病房病原菌流行菌株及其耐药特点分析. 中华医院感染学杂志, 2010, 20(21): 3414-3416.
4. 刘振华, 李彦, 贾淑琴, 等. 重症监护病房病原菌分布与耐药分析. 中华医院感染学杂志, 2009, 19(22): 3116-3118.
5. 李六亿, 刘玉树. 医院感染管理学. 北京: 人民卫生出版社, 2010: 27-276.
6. 富秀玉, 马桂霞. 医院多药耐药菌目标监测的调查与干预措施. 中华医院感染学杂志, 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. 崔红, 姜振环, 李宏, 等. 医务人员手卫生与医院感染的管理对策. 中华医院感染学杂志, 2010, 20(22): 3448.
9. 徐艳, 牟霞, 杨怀, 等. 组合干预对多药耐药菌感染预防控制的调查研究. 中华医院感染学杂志, 2013, 23(20): 5048-5050.
10. 唐红萍, 高晓东, 樊春笋, 等. 主动筛查与组合干预对ICU多药耐药菌感染患者的效果评价. 中华医院感染学杂志, 2015, (11): 2484-2486.
11. 许瑞宝, 叶丽娟. 预防多重耐药菌感染暴发流行的护理探讨. 中国实用医药, 2010, 5(26): 215-216.
12. 朱立红, 沈元, 张申, 等. 医务人员手卫生执行率与干预方法的调查. 中华医院感染学杂志, 2008, 18(4): 542-544.
13. 游建萍, 黄庆, 府伟灵, 等. 手卫生所致医院感染的预防和控制措施的探讨. 中华医院感染学杂志, 2005, 15(4): 426-428.
14. 周艳霞, 钟元河, 尹云清, 等. 关于医务人员手卫生质量管理调查报告. 中国消毒学杂志, 2007, 24(2): 165-167.
15. 王雪文, 顾克菊, 金珠, 等. ICU多重耐药菌感染流行趋势及控制措施. 护士进修杂志, 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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