Efficacy of targeted monitoring and intervention on multidrugresistant organisms in intensive care units

Abstract:

ObjectiveTo understand the status of infection with multidrugresistant organisms (MDROs) in intensive care units(ICUs), and evaluate the intervention efficacy of targeted monitoring.MethodsProspective study was adopted, patients who were admitted to ICUs in 2014-2015 were selected (JanuaryDecember 2014 was as preintervention stage, JanuaryDecember 2015 was as intervention stage), trend of MDRO infection before and after intervention were compared and analyzed.ResultsBefore and after intervention, 297 and 217 strains of MDROs were isolated respectively, except carbapenemresistant Pseudomonas aeruginosa (CRPA), the isolated strains of carbapenemresistant Acinetobacter baumannii (CRAB), carbapenemresistant Enterobacteriaceae (CRE), methicillinresistant Staphylococcus aureus(MRSA), and vancomycinresistant Enterococcus (VRE) declined after intervention. MDRO infection rate declined from 7.17 ‰ before intervention to 3.88‰ after intervention, infection rate of CRAB and CRE after intervention were both lower than before intervention (both P<0.05); MDRO infection rates in general ICU and internal medicine ICU increased from 8.75‰ and 7.84‰ before intervention to 4.39‰ and 2.28‰ after intervention, respectively (both P<0.05). After taking comprehensive intervention measures, compliance to prevention and control measures, such as ordering rate of doctor’s advice on contact isolation for 24 hours, hand hygiene, health care workers’ awareness all enhanced significantly(all P<0.05).ConclusionTargeted monitoring and intervention measures can reduce isolation rate of MDROs in ICUs.