| 孟进松,肖 荣,林国安,杨晓东,李文军,袁仕安.病房装修辅助其它措施预防烧伤耐药杆菌感染[J].中国烧伤创疡杂志,2015,(5):339~345. |
| DOI： |
| 中文关键词: 病房装修 铜绿假单胞菌 鲍曼不动杆菌 药敏试验 细菌感染 |
| 英文关键词:Ward remodeling Pseudomonas aeruginosa Acinetobacter Bauman Drug sensitive test Bacterial infection |
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| 中文摘要: |
| 目的 临床研究病房装修在减少耐药菌株，提高药物敏感率，预防烧伤耐药菌感染中的作用。方法 自2012年2月19日装修后的病房投入使用以后,辅助常规的消毒隔离、控制抗菌药物应用、病房轮流空置、外院转入患者先住指定病房等综合措施预防烧伤耐药杆菌感染，并2012年3月2013年4月30日期间收治的421例患者的2484例标本与2010年1月1日至2011年10月29日期间收治的458例患者的2564例标本进行比较，采用卡方检验对比研究两者检出的细菌及抗菌药物敏感情况。结果 细菌培养结果表明，病房装修前的2564例标本中，细菌阳性率为87.21％，抗菌药物敏感率大于60.00％的药物较少，对多重耐药铜绿假单胞菌常用的抗菌药物均耐药；而病房装修后的2484例标本中，细菌阳性率为69.10％（p<0.01），出现了5种敏感率大于60.00％的抗菌药物，其中亚胺培南西司他丁为78.31％，舒普深（头孢哌酮钠舒巴坦钠）为66.30％。多重耐药鲍曼不动杆菌只有1种比较敏感的抗菌药物，即舒普深，敏感率由装修前的60.00％ 提高到装修后的88.74％ （p<0.01）；耐甲氧西林金黄色葡萄球菌（MRSA）敏感率大于60.00％的抗菌药物只有万古霉素，敏感率为100％。结论 病房装修辅助消毒隔离、控制抗菌药物应用、病房轮流空置及外院转入患者先住指定病房等综合措施，能明显降低烧伤病房细菌数量，提高耐药菌对抗菌药物的敏感率，有利于预防烧伤耐药菌感染。 |
| 英文摘要: |
| Objective Clinically study the effects of ward remodeling on reducing the species of drug resistant pathogenic germs, improving drug sensitivity, and preventing the infection of drug resistant bacteria in burns. Methods Since February 19, 2012, the remodeled wards have been put into use with comprehensive management of routine disinfection and isolation, control of the use of antibacterial drugs, emptying the wards in turn, assigning certain wards to the patients transferred from other hopitals at admission, etc. The 2484 samples of 421 patients admitted between March 1, 2012 and April 30, 2013 were compared to the 2564 samples of 458 patients admitted between January 1, 2010 to October 29, 2011. Chi-square tests were used for comparative study on the bacteria detected and the sensitivity to antibacterial drugs in the two groups. Results The germiculture results showed that, before ward remodeling, the bacteria positive rate was 87.21% in the 2564 samples, little drug has sensitivity rate over 60%, and the bacteria are resistant to all the conventional antibacterial drug for multi-drug resistant pseudomonas aeruginosa. While after remodeling, the bacteria positive rate was 69.10% in the 2484 samples（P<0.01）and 5 drugs have a sensitivity rate over 60.00% , among which the sensitivity rate of Imipenem and Cilastatin were 78.31% and the sensitivity rate of Sulperazone (Cefoperazone sodium/Sulbactam sodium) was 66.30%. The multi-drug resistant Acinetobacter Bauman was only sensitive to one kind of antibiotic, Sulperazone, with an improvement of the sensitivity rate from 60.00% remodeling to 88.74% after the remodeling（P<0.01）. And only Vancomycin had over 60% sensitivity rate to methicillin-resistant staphylococcus aureus and the sensitivity rate was 100%. Conclusion Comprehensive management of routine disinfection and isolation, control of the use of antibacterial drugs, emptying the wards in turn, assigning certain wards to the patients transferred from other hopitals at admission, etc. remodeling Ward remodeling can significantly reduce the amount of bacteria in the burn wards, and increase the sensitivity rate of the antibacterial drugs in drug-resistant bacteria, which is good for preventing infection ofthe drug-resistant bacteria in burns. |
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