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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
    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 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.
    Prevention and control measures for patients with multidrug resistant strains:
    (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) when nursing multiple drug resistant bacteria infected or colonized, the group should be divided into groups and the personnel are relatively fixed.
    (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 should be equipped with sufficient and convenient personal protective equipment, such as medical masks, hats, gloves, goggles, protective cover, isolation clothing, etc.
    (5) general medical instruments such as groups tips stethoscope, percussion hammer, flashlight, etc.) for bed special tape
    (6) medical equipment and equipment should be dedicated to special persons, or one disinfection should be used.
    (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) 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) 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) 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) medical waste: a yellow garbage bag with a yellow garbage bucket covered with cover and closed transportation.
    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.
    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.
    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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