Effect of one year's comprehensive intervention measures of multidrug-resistant bacteria management by a general hospital

CHEN Fei; QI Shao-yun; FENG Wen-ting

doi:10.3969/j.issn.1007-8134.2018.02.016

Abstract：Objective To investigate the effect of infection control interventions on reducing the infection rate of multidrug-resistant bacteria in the hospital, and provide evidence for developing a variety of prevention and control measures. Methods Since December 2014, comprehensive intervention measures of multidrug-resistant bacteria management have been strictly implemented in Lu'an Affiliated Hospital of Anhui Medical University. The inpatients were included in this study from January 1, 2014 to December 31, 2015. According to the statistical results of the usage rate and use intensity of antibiotics, as well as the microbiology specimen submission rate, patients with multidrug-resistant infection or colonization were further analyzed. The implementation of prevention and control measures in wards, the detection rate of multidrug-resistant bacteria and the incidence of nosocomial infections caused by multidrug-resistant bacteria were respectively calculated. Results Compared with data in 2014, the usage rate of antibiotics in 2015 was decreased and the microbiology specimen submission rate was increased when patients were treated with antibiotics. The detection rate of carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Klebsiella pneumoniae (CRKP) were decreased significantly, while the detection rate of Klebsiella pneumoniae producing extended spectrum β-lactamases (ESBLs) was increased. The placement rate of isolation signs, the implementation rate of hand hygiene facilities and the correct disposal rate of patients' living garbage were all increased. The incidence of nosocomial infections caused by CRKP and Klebsiella pneumoniae producing ESBLs were decreased, and the difference was statistically significant (P < 0.05). The incidence of nosocomial infections caused by carbapenem-resistant Acinetobacter baumannii and CRPA were decreased, and the incidence of nosocomial infections caused by methicillin-resistant Staphylococcus aureus and Escherichia coli producing ESBLs was increased, but the difference was not statistically significant (P>0.05). Conclusions The rational use of antibiotics, reducing the usage rate of antibiotics, and implementing prevention and control measures in the wards can effectively reduce the incidence of nosocomial infections caused by multidrug-resistant bacteria.