Objective To explore the effect of applying an information management system to the prevention and control of multidrug-resistant organisms (MDROs) infection.
Methods The implementation rate of MDROs prevention and control measures, the incidence of nosocomial MDRO infections, and the detection rate of environmental MDROs were compared and analyzed for medical staff before and after the implementation of the information management system in Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology.
Results After the implementation of the information management system, except the compliance rate among technicians for "Wearing isolation gowns during close-range operations", the implementation rates of other MDROs prevention and control measures for doctors, nurses and technicians were significantly higher than before (P<0.001). However, the implementation rate among doctors for "Following hand hygiene procedures strictly", "Wearing isolation gowns dur-ing close-range operations", "Finally arranging ward rounds or diagnosis and treatment operations" and for nurses "Isolating patients and special items of equipment " and "Wearing isolation gowns during close-range operations" and for technicians "Wearing isolation gowns during close-range operations" were still lower than 80%. The incidence of nosocomial MDRO infections had decreased significantly from 0.34% before to 0.25% after the implementation of the information management (P<0.001). The detection rates of methicillin-resistant staphylococcus aureus, car-bapenem-resistant acinetobacter baumannii and carbapenem-resistant enterobacter on the ward environmental sur-faces were significantly lower than before (P<0.001).
Conclusion The application of the information manage-ment system had a significant effect on the management of MDROs, thus providing strong support for its use in the prevention and control of the spread and outbreak of MDROs, as well as ensuring the quality and safety of medical care.
1.Kyaw MH, Kern DM, Zhou S, et al. Healthcare utilization and costs associated with S. aureus and P. aeruginosa pneumonia in the intensive care unit: a retrospective observational cohort study in a US claims database[J]. BMC Health Serv Res, 2015, 15(1): 241. DOI: 10.1186/s12913-015-0917-x.
2.Heidenreich D, Kreil S, Jawhar M, et al. Course of colonization by multidrug-resistant or-ganisms after allogeneic hematopoietic cell transplantation[J]. Ann Hematol, 2018, 97(12): 2501-2508. DOI: 10.1007/s00277-018-3475-6.
3.Li Y, Cao X, Ge H, et al. Targeted surveillance of nosocomial infection in intensive care units of 176 hospitals in Jiangsu province, China[J]. J Hosp Infect, 2018, 99(1): 36-41. DOI: 10.1016/j.jhin.2017.10.009.
4.陈皇胜, 张振伟, 吴文溢,等. 多重耐药菌感染对骨科伤口感染治疗效果的影响[J]. 中华医院感染学杂志, 2019, 29(16): 2478-2481. [Chen HS, Zhang ZW, Wu WY, et al. Study on effect of multidrug-resistant bacteria on the treatment effect of orthopedic wound infection[J]. Chinese Journal of Nosocomiology, 2019, 29(16): 2478-2481.] DOI: 10.11816/cn.ni.2019-182199.
5.胡付品, 郭燕, 朱德妹, 等. 2017年CHINET中国细菌耐药性监测[J]. 中国感染与化疗杂志, 2018, 18(3): 241-251. [Hu FP, Guo Y, Zhu DM, et al. Antimicrobial resistance profile of clinical isolates in hospitals across China: report from the CHINET Surveillance Program, 2017[J]. Chinese Journal of Infection and Chemotherapy, 2018, 18(3): 241-251.] DOI: 10.16718/j.1009-7708.2018. 03.001.
6.胡付品, 郭燕, 朱德妹, 等. 2020年CHINET中国细菌耐药监测[J]. 中国感染与化疗杂志, 2021, 21(4): 377-387. [Hu FP, Guo Y, Zhu DM, et al. CHINET surveillance of bacterial resistance: results of 2020[J]. Chinese Journal of Infection and Chemotherapy, 2021, 21(4): 377-387.]DOI: 10.16718/j.1009-7708.2021.04.001.
7.陈琳, 杨小燕, 许小敏, 等. 加强对碳青霉烯类抗菌药物使用管理的效果评价[J]. 中华医院感染学杂志, 2017, 27(8): 1897-1900. [Chen L, Yang XY, Xu XM, et al. Evaluation of the effect of strengthening the management of carbapenem antibiotics[J]. Chinese Journal of Nosocomiology, 2017, 27(8): 1897-1900.] DOI: 10.11816/cn.ni.2017-170447.
8.马文晖, 王力红, 张京利, 等. 医院感染病例监测系统应用实践[J]. 中华医院管理杂志, 2019, 35(5): 395-397. [Ma WH, Wang LH, Zhang JL, et al. Application practice of case surveillance system for healthcare-associated infections[J]. Chinese Journal of Hospital Administration, 2019, 35(5): 395-397.] DOI: 10.3760/cma.j.issn.1000-6672.2019.05.011.
9.佟青, 张一兵, 白璐. 医院感染多系统网络信息化交互性管理的实践与实效[J]. 中华医院感染学杂志, 2013, 23(23): 5759-5761. [Tong Q, Zhang YB, Bai L. The practice and effectiveness of network information interactive management of nosocomial infection[J]. Chinese Journal of Nosocomiology, 2013, 23(23): 5759-5761.] http://med.wanfangdata.com.cn/Paper/Detail?id=PeriodicalPaper_zhyygrxzz201323049.
10.徐艳, 杨怀, 牟霞, 等. 多药耐药菌感染及定植患者信息精准化管理研究[J]. 中华医院感染学杂志, 2016, 26(11): 2414-2417. [Xu Y, Yang H, Mu X, et al. Research on precise management of information of infection and colonization with multidrug-resistant organisms[J]. Chinese Journal of Nosocomiology, 2016, 26(11): 2414-2417.] DOI: 10.11816/cn.ni.2016-161225.
11.赵文英, 王琴, 金章英, 等. 信息化与危急值管理在提高多药耐药菌预防控制执行力中的应用[J]. 中华医院感染学杂志, 2015, 25(24): 5716-5718. [Zhao WY, Wang Q, Jin ZY, et al. Application of information and critical value management in improving prevention and controlling of multi-drug resistant bacteria[J]. Chinese Journal of Nosocomiology, 2015, 25(24): 5716-5718.] DOI: 10.11816/cn.ni.2015-150243.
12.中华人民共和国卫生部.医院感染诊断标准(试行)[J]. 中华医学杂志, 2001, 81(5): 61-67. [Ministry of Health of the People's Republic of China. Diagnostic criteria for nosocomial infections(proposed)[J]. National Medical Journal of China, 2001, 81(5): 61-67.] DOI: 10.3760/j:issn:0376-2491.2001.05.027.
13.黄勋, 邓子德, 倪语星, 等. 多重耐药菌医院感染预防与控制中国专家共识[J]. 中国感染控制杂志, 2015, 14(1): 1-9. [Huang X, Deng ZD, Ni YX, et al. Chinese experts' consensus on prevention and control of multidrug resist-ance organism healthcare-associated infection[J]. Chinese Journal of Infection Control, 2015, 14(1): 1-9.]DOI: 10.3969/j.issn.1671-9638.2015.01.001.
14.中华人民共和国国家卫生健康委员会. 医疗机构消毒技术规范[EB/OL]. (2012-08-01) [2021-08-23]. http://www.nhc.gov.cn/wjw/s9496/201204/54510.shtml.
15.尚红, 王毓三, 申子瑜. 全国临床检验操作规程(第四版)[M]. 北京: 人民卫生出版社, 2015.
16.Chen Y, Pan C, Chen S, et al. The impact of bundle care on preventing healthcare-associated infections in an intensive care unit at a local hospital in Taiwan[J]. Int J Antimicrob Ag, 2017, 50(S2): S238-S239. DOI: 10.1016/S0924-8579 (17)30423-5.
17.Gupta SK, Al Khaleefah FK, Al Harbi IS, et al. An intervention study for the prevention and control of health care-associated infection in the critical cares area of a tertiary care hospital in Saudi Arabia[J]. Indian J Crit Care, 2018, 22(12): 858-861. DOI: 10.4103/ijccm.IJC CM_270_18.
18.Alp E, Cookson B, Erdem H, et al. Infection control bundles in intensive care: an interna-tional cross-sectional survey in low- and middle-income countries[J]. J Hosp Infect, 2019, 101(3): 248-256. DOI: 10.1016/j.jhin.2018.07.022.
19.Tacconelli E, Cataldo MA, Dancer SJ, et al. ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant gram-negative bacteria in hospitalized patients[J]. Clin Microbiol Infec, 2014, 201(S1): 1-55. DOI: 10.1111/1469-0691.12427.
20.Quan KA, Cousins SM, Porter DD, et al. Automated tracking and ordering of precautions for multidrug-resistant organisms[J]. Am J Infect Control, 2015, 43(6): 577-580. DOI: 10.1016/j.ajic.2014.12.019.
21.Katanami Y, Hayakawa K, Shimazaki T, et al. Adherence to contact precautions by different types of healthcare workers through video monitoring in a tertiary hospital[J]. J Hosp Infect, 2018, 100(1): 70-75. DOI: 10.1016/j.jhin.2018.01.001.