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  • 重症监护室的多重耐药菌防控
    来源:http://www.moptuan.com 浏览: 发布日期:2018-02-14
    重症监护室(ICU)是危重患者的集中区,也是医院感染高危区,根据流行病学特点来说,不同科室的医院感染率有很大差异,通常认为重症监护病房发病率高,医院级别越高,感染发病率越高。医院感染的危害不仅表现为增加患者的发病率和病死率,增加患者的痛苦及医务人员工作量,还给患者及社会造成重大的经济损失。
    Intensive care unit (ICU) is the focus area of critically ill patients, the hospital infection is also a high-risk area, according to epidemiological characteristics, different departments of the hospital infection rate is very different, usually considered ICU incidence is highest, the higher level of hospital infection, the higher the incidence. The harm of hospital infection is not only manifested in increasing the morbidity and mortality of patients, increasing the pain of patients and the workload of medical staff, but also causing significant economic losses to patients and society.
    ICU在世界上有30多年的历史了,现已成为医院中危重病人的抢救中心。ICU的监护水平如何,设备是否先进,已成为衡量一个医院水平的重要标志。医疗机构往往会在ICU的人力配备上给予佳保障,以期得到良好的救治效果。
    ICU has a history of more than 30 years in the world, and has now become the rescue center of critical patients in the hospital. The monitoring level of ICU and the advanced equipment have become an important sign to measure the level of a hospital. The medical institutions often give the best support to the ICU staffing in order to get good treatment.
    多重耐药菌株患者的防控措施:
    Prevention and control measures for patients with multidrug resistant strains:
    (1)患者安置:宜单间隔离;如隔离房间不足,可将同类耐药菌感染或定植患者集中安置,并设醒目的标识
    (1) patient placement: appropriate isolation; if the isolation room is insufficient, the patients with similar resistance bacteria or colonization can be placed in a centralized way and set up a waking sign.
    (2)护理多重耐药菌感染或定植患者时,宜分组进行,人员相对固定。
    (2) when nursing multiple drug resistant bacteria infected or colonized, the group should be divided into groups and the personnel are relatively fixed.
    (3)操作前后严格执行手卫生,并配备足够的非手触式洗手设施和速干手消毒剂。
    (3) hand hygiene is strictly carried out before and after operation, and sufficient non hand touch hand washing facilities and fast drying hand disinfectant are equipped.
    (4)ICU应配备足量的、方便取用的个人防护用品,如医用口罩、帽子、手套、护目镜、防护面罩、隔离衣等。
    (4) ICU should be equipped with sufficient and convenient personal protective equipment, such as medical masks, hats, gloves, goggles, protective cover, isolation clothing, etc.
    (5)—般性诊疗器械如卩听诊器、叩诊锤、手电筒、软尺等)专床专用
    (5) general medical instruments such as groups tips stethoscope, percussion hammer, flashlight, etc.) for bed special tape
    (6)医疗器械、设备应专人专用,或一用一消毒。。
    (6) medical equipment and equipment should be dedicated to special persons, or one disinfection should be used.
    (7)医疗区域的物体表面应每天清洁消毒1〜2次,达到中水平消毒;
    (7) the surface of the medical area should be cleaned and sterilized every day from 1 to 2 times to reach the medium level disinfection.
    (8)物体表面应保持清洁,被患者血液、体液、排泄物、分泌物等污染时,应随时清洁并消毒;
    (8) the surface of the object should be kept clean, and should be cleaned and sterilized at any time when it is contaminated by the blood, body fluid, excreta and secretions of the patient.
    (9)计算机键盘宜使用键盘保护膜覆盖,表面每天清洁消毒1〜2次;
    (9) the computer keyboard should be covered with a keyboard protection film, and the surface is cleaned and sterilized every day from 1 to 2 times.
    (10)地面、床栏、床旁桌、床头柜等应每天清洁消毒1〜2次,达到中水平消毒。
    (10) ground, bed hurdles, bedside tables and bedside cabinets should be cleaned and sanitized 1 to 2 times a day to reach the level of middle level disinfection.
    (11)医疗废物:带盖黄色垃圾桶套双层黄色医疗垃圾袋,密闭运送。
    (11) medical waste: a yellow garbage bag with a yellow garbage bucket covered with cover and closed transportation.
    在重症监护病房(ICU)中,广谱头孢菌素耐药肠杆菌科细菌(ESCs)感染在全球范围内看,至少部分是由交叉传播引起的。然而,细菌的个体传播能力尚未量化。
    In the intensive care unit (ICU), broad-spectrum cephalosporin resistant Enterobacteriaceae (ESCs) infection is seen worldwide, at least partly due to cross transmission. However, the individual transmission ability of bacteria has not been quantified.
    在对13个欧洲ICU进行的多中心研究的事后分析中,使用了前瞻性监测数据和数学模型来估计广谱头孢菌素耐药的大肠杆菌和非大肠杆菌的肠杆菌科(non-EcE)的传播能力和单次入院繁殖数(RA)。监测是基于对广谱头孢菌素耐药肠杆菌科细菌的显色选择性培养基,能鉴定大肠埃希菌组和非ECE组如克雷伯菌属、肠杆菌属、沙雷氏菌属和柠檬酸杆菌属。
    In a multicenter study of 13 European ICU after the analysis, the use of prospective monitoring data and mathematical model to estimate the Enterobacteriaceae spectrum cephalosporin resistant Escherichia coli and Escherichia coli (non-EcE) the ability to transmit and single admission reproduction number (RA). Monitoring is based on the chromogenic selective medium of broad-spectrum cephalosporin resistant Enterobacteriaceae. It can identify Escherichia coli group and non ECE group, such as Klebsiella, enterobacterium, Serratia and citrobacilli.
    应常规监测ICU患者医院感染发病率、感染部位构成比、病原微生物等,做好医院感染监测相关信息的记录。为医院感染的预防、控制和管理提供科学依据。
    The incidence of nosocomial infection, the constituent ratio of the infection site and the pathogenic microorganism should be monitored routinely, and the related information of hospital infection monitoring should be well recorded. It provides a scientific basis for the prevention, control and management of hospital infection.

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