Application of active screening to prevent and control multidrug-resistant organism infection in patients in intensive care unit
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Department of Critical Care Medicine, Yichang Central Peoples' Hospital, First Clinical Medical College of Three Gorges University, Yichang 443003, China

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+2  R197.323.4]]>

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    Abstract:

    Objective To analyze the role of active screening in the prevention and control of multidrug-resistant organism (MDRO) infection in intensive care unit (ICU) through active screening on patients in ICU. Methods Patients who were admitted to the emergency ICU of a hospital from January 1, 2017 to December 31, 2020 were selected, patients who didn't conduct active screening from 2017 to 2018 were in control group, those who underwent active screening from 2019 to 2020 were in intervention group. Infection status, MDRO infection and adverse medical events of two groups of patients were compared. Results A total of 1 834 patients were in control group, incidence of healthcare-associated infection (HAI) was 7.91%; 1 636 patients were in intervention group, HAI rate was 5.26%; there was significant difference between two groups (P=0.002). 58 patients (3.16%) in control group and 33 patients (2.02%) in intervention group had MDRO infection, there was significant difference between two groups (P=0.035). Case infection rates of carbapenem-resistant Acinetobacter baumannii (CRAB), multidrug-resistant/pandrug-resistant Pseudomonas aeruginosa (MDR/PDR-PA) and extended-spectrum β-lactamases(ESBLs)-producing bacteria in intervention group were all lower than those in control group (all P < 0.05). MDRO respiratory tract infection rates in control group and intervention group were 2.84% and 1.77% respectively, there was significant difference between two groups (P=0.038). The average total hospitalization days and ICU hospita- lization days in intervention group were both lower than those in control group (both P < 0.05). Incidence of adverse medical events in patients with MDRO infection in intervention group was lower than that in control group (6.06% vs 25.86%), difference was statistically significant (P=0.006). There was no significant difference in positive rate of active screening and that of bacterial culture (P=0.067), the sensitivity and specificity of active screening were 87.13% and 97.29% respectively. Conclusion Implementation of active screening can early identify MDRO car-riers, understand MDRO infection and colonization as early as possible, reduce HAI rate and MDRO infection rate of ICU patients, and reduce hospitalization days and incidence of adverse medical events.

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陈玉,张朝辉,樊发超.应用主动筛查预防与控制重症监护病房患者多重耐药菌感染[J].中国感染控制杂志英文版,2022,(2):190-195. DOI:10.12138/j. issn.1671-9638.20221643.
Yu CHEN, Chao-hui ZHANG, Fa-chao FAN. Application of active screening to prevent and control multidrug-resistant organism infection in patients in intensive care unit[J]. Chin J Infect Control, 2022,(2):190-195. DOI:10.12138/j. issn.1671-9638.20221643.

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History
  • Received:July 12,2021
  • Revised:
  • Adopted:
  • Online: April 28,2024
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