The Effect of Infection Control Nurses on the Occurrence of Pseudomonas aeruginosa Healthcare-Acquired Infection and Multidrug-Resistant Strains in Critically-Ill Children.
The Effect of Infection Control Nurses on the Occurrence of Pseudomonas aeruginosa Healthcare-Acquired Infection and Multidrug-Resistant Strains in Critically-Ill Children.
复制标题
感染控制护士对危重儿童铜绿假单胞菌医疗获得性感染和多重耐药菌株发生的影响。
DOI：
10.1371/journal.pone.0143692
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Wang L
中科院分区：
文献类型：
--
作者：
Xu W;He L;Liu C;Rong J;Shi Y;Song W;Zhang T;Wang L
儿科重症监护病房（PICU）中铜绿假单胞菌（P. aeruginosa）感染发病率高，增加了治疗费用和死亡率，严重威胁危重患儿的生命安全。寻求方便有效的方法控制和预防卫生保健获得性感染（HAI）至关重要。本研究旨在探讨儿科重症监护病房（PICU）感染控制护士对铜绿假单胞菌HAI和多药耐药（MDR）菌株发生的影响。临床资料分为两组，年龄1个月~ 14岁。一组危重患者（N = 3，722）于2007年至2010年入住PICU，无感染控制护士管理。另一组危重患者（N = 3，943）于2011年至2013年入住PICU，由感染控制护士管理。比较两组患者的死亡率、患病率及获得性铜绿假单胞菌感染发生率，评价护理人员感染控制的效果。实施感染控制护士岗位后，患者总体死亡率由4.81%下降到3.73%。气管插管时间超过48小时的患者中，气管插管相关性肺炎的发生率从44.6%下降到34.32%。气管插管患者的死亡率从16.96%下降到10.17%，铜绿假单胞菌HAI的发生率从1.89%下降到1.07%。耐药率（MDR）从67.95%下降到44.23%。两组比较有显著性差异（p<0.05）。实施感染控制护士岗位与有效降低HAI率，尤其是铜绿假单胞菌HAI的发生率和发病率、降低PICU病死率、改善铜绿假单胞菌耐药性有关。
Healthcare-acquired Pseudomonas aeruginosa (P. aeruginosa) infections in the Pediatric Intensive Care Unit (PICU), which have a high incidence, increase treatment costs and mortality, and seriously threaten the safety of critically ill children. It is essential to seek convenient and effective methods to control and prevent healthcare-acquired infections (HAIs). This research was conducted to study the effect of infection control nurses on the occurrence of P. aeruginosa HAIs and multi-drug resistance (MDR) strains in PICU. The clinical data was divided into two groups, with the age ranging from 1 month to 14 years. One group of the critically ill patients(N = 3,722) was admitted to PICU from 2007 to 2010, without the management of infection control nurses. The other group of the critically ill patients (N = 3,943) was admitted to PICU from 2011 to 2013, with the management of infection control nurses. Compare the mortality, morbidity and the incidence of acquired P. aeruginosa infections to evaluate the effect of infection control nurses. After implementation of the post of infection control nurses, the patient's overall mortality fell from 4.81% to 3.73%. Among the patients with endotracheal intubation more than 48 hours, the incidence of endotracheal intubation-related pneumonia decreased from 44.6% to 34.32%. The mortality of patients with endotracheal intubation decreased from 16.96% to 10.17%, and the morbidity of HAIs with P. aeruginosa decreased from 1.89% to 1.07%. The mutual different rate (MDR) dropped from 67.95% to 44.23%. There were remarkable differences in these rates between the two groups (p<0.05). Implementing the post of infection control nurses is associated with effectively reducing the HAI rate, especially the incidence and morbidity of P. aeruginosa HAIs, reducing PICU mortality, improving P. aeruginosa drug resistance.