抗生素管理及手卫生对新生儿耐碳青霉烯类肠杆菌科细菌感染的影响-儿科学专业毕业论文.docxVIP

重庆医 重庆医科大学硕士研究生学位论文 万方数据 万方数据 英汉缩略语名词对照 英文缩写 CRE 英文全称 Carbapenem-resistant enterobacteriaceae 中文全称 耐碳青霉烯类肠杆菌科细菌 DDDs Defined daily dose 用药频度 AUD Antibiotics use density 抗生素使用强度 ESBLs CAP Extended spectrum beta-lactamases Community acquired pneumonia 超广谱 β-内酰胺酶 社区获得性肺炎 HAP Hospital acquired pneumonia 医院获得性肺炎 MDRO Multidrug-resistant organism 多重耐药菌 WHO World Health Organization 世界卫生组织 NICU Neonatal intense care unit 新生儿重症监护病房 NEC Necrotizing enterocolitis of newborn 新生儿坏死性小肠结肠炎 SBI Serious bacterial infection 严重细菌感染 GBS PCT Group B streptococcus Procalcitonin B 族链球菌 降钙素原 CRP C-reaction protein C 反应蛋白 1 抗生素管理及手卫生对新生儿耐碳青霉烯类肠杆菌 科细菌感染的影响 摘 要 目的：探讨抗生素和手卫生规范管理对防控新生儿碳青霉烯类耐 药肠杆菌科细菌(CRE)感染的意义。 方法：根据医院抗菌药物专项整治情况，将 2011 年 1 月至 2013 年 12 月划分为整治前期、过渡期以及整治后期，对同期新生儿病房抗 生素使用强度、医务人员手卫生依从率、CRE 检出率以及院内感染百 分率等指标进行回顾性分析。 结果：抗生素使用强度从 12.93 DDDs 降至 8.10 DDDs，医务人员 手卫生依从率从 53.49%升至 83.33%，肠杆菌科细菌 CRE 检出率由 3.71%降至 2.27%，差异有统计学意义(P0.01)；院内 CRE 感染率由 0.22%降至 0.17%，但未达统计学意义(P=0.441)。 结论：合理应用抗生素、推行手卫生可作为经济有效的新生儿 CRE 感染防治措施。 关键词：碳青霉烯类耐药的肠杆菌科细菌; 抗生素; 手卫生; 新 生儿 2 THE EFFECT OF STANDARDIZED USAGE OF ANTIBIOTICS AND HAND HYGIENE ON CARBAPENEM-RESISTANT ENTEROBACTERIACEAE INFECTION IN NEONATES ABSTRACT Objective:To investigate the effect of standardized usage of anti- biotics and hand hygiene on carbapenem-resistant enterobacteriaceae(C RE) infection in neonates. Methods:According to the situation of standardized management of antibiotics in our hospital, the study period, from January 2011 to December 2013, was divided into pre-intervention, transition and post-intervention. Retrospective study was employed to analyze the antibiotics use density (AUD), the hand hygiene compliance rate among the medical staff, the positive rate of CRE and the nosocomial infection percentage of the neonatology department. Results:From pre-intervention to post-intervention period, the AUD was decreased from 12.93 DDDs to 8.10 DDDs; hand hygiene compliance rate of medical staff was increased from 53.49% to 83.33%; the dete