采用信息化技术实时标识与预警耐药菌

Real-time identification and early warning on drug-resistant bacteria by information technology

摘要:

目的 探讨通过信息化技术实时标识与预警耐药菌的方法，以便临床及时获取耐药菌信息。方法 2015年对HIS、LIS、医院感染监测三方系统接口进行改造，以HL7为接口框架设计标准、LIS为基准数据源以及HIS为患者信息库，在常用界面实现多方信息交互，对检出的耐药菌进行标识和预警，比较信息化前后耐药菌识别情况。结果 通过信息化建设，信息化界面显示，耐药菌判定规则可以随意变动，数据结果更准确、及时。每日人工审核判定时间由30 min缩减至2 min，在任何内网计算机临床工作人员均可实时并方便地获得耐药菌信息。对耐药菌进行及时标识及干预后，2015—2017年医院感染控制重点科室耐药菌检出株数分别为284、289、309株，耐药菌床日获得率分别为9.23‰（284/30 773）、8.91‰（289/32 429）、8.34‰（309/37 031），耐药菌床日获得率略有下降。结论 利用信息化技术，实时发现耐药菌，并对新发耐药菌进行及时标识与干预，有效降低耐药菌感染率。

Abstract:

Objective To explore the method of real-time identification and early warning of drug-resistant bacteria through information technology, timely obtain information about drug-resistant bacteria in clinic. Methods Interface of Hospital Information System (HIS), Laboratory Information Management System (LIS) and healthcare-associated infection (HAI) surveillance system were reconstructed in 2015, HL7 was used as interface framework to design standard, LIS was as baseline data source and HIS as patient information database, multi-information exchange was implemented on the commonly used interface, identification and early warning of detected drug-resistant bacteria was conducted, identification of drug-resistant bacteria before and after informationization was compared. Results Through the information construction, the information interface showed that the rules of drug-resistant bacteria determination can be changed at will, data results were more accurate and timely. The judgment time of manual review was reduced from 30 minutes to 2 minutes every day, information of drug-resistant bacteria can be obtained timely and conveniently on any internal network computer by clinical staff. After timely identification and intervention of drug-resistant bacteria, 284, 289 and 309 strains of drug-resistant bacteria were detected in key departments of HAI control in 2015-2017, drug-resistant bacteria per 1 000 bed-day were 9.23‰ (284/30 773), 8.91‰ (289/32 429), and 8.34‰ (309/37 031)respectively, with a slight decrease. Conclusion Through information technology, drug-resistant bacteria can be found timely, and new drug-resistant bacteria can be identified and intervened in time, so as to effectively reduce the infection rate of drug-resistant bacteria.