ObjectiveTo optimize procedures of going out for examination for patients with multidrug-resistant organism, strengthen prevention and control management of nosocomial infection, and prevent nosocomial infection.MethodsPatients with multidrug-resistant organism who went out for examination were selected from April to November 2018. April to July 2018 (before implementation) was process construction stage, and August to November 2018 (after implementation) was process optimization implementation stage. In April 2018, process and management system of going out for multidrug-resistant organism patients were formulated, training of transporters was strengthened, and measures such as checklist identification, accompany patients for examination, patient handover, isolation and protection, and disinfection of materials were implemented, to realize the infection prevention and control management in the whole process of going out for multidrug-resistant organism patients. We compared relevant indicators before and after implementation.ResultsA total of 262 cases times of patients with multidrug-resistant organism were included, including 134 cases times before implementation and 128 cases times after implementation. Compared with before implementation, the hand hygiene, wearing gloves, disinfection of inspection instruments and articles, patient transfer, isolation measures in waiting process (special elevator, isolation after waiting for inspection, arrange inspection time reasonably), education and training after implementation improved(P<0.05). Before and after implementation, the Methicillin resistant staphylococcus aureus detection rate difference was statistically significant (P<0.05).ConclusionsThe optimization of procedures of examination for patients with multidrug-resistant organism can increase implementation rate of indirect indicators such as hand hygiene, disinfection of inspection instruments and articles, isolation and protection, education and training in the prevention and control of multidrug-resistant organism in nosocomial infection. And it is important for the prevention and control of multi-disciplinary collaboration of multidrug-resistant organism.
ObjectiveTo analyze the risk factors of multidrug-resistant organism (MDRO) nosocomial infection, and to provide the scientific basis for the prevention and control of MDRO nosocomial infection.MethodsPatients with MDRO in Chengdu Shangjin Nanfu Hospital from 2014 to 2015 were retrospectively collected. The patients were divided into the MDRO nosocomial infection group and the MDRO non-nosocomial infection group. The MDRO infection/colonization, bacterial strain type, specimens type and distribution characteristics of clinical departments were analyzed. Single factor and multiple factor logistic regression analysis were used to analyze the risk factors of MDRO nosocomial infection.ResultsA total of 357 patients of MDRO infection/colonization were monitored, of which 147 times (144 patients) were with nosocomial infections and 213 times (213 patients) were without nosocomial infections. MDRO nosocomial infection incidence rate/cases incidence rate were 0.18%. A total of 371 MDRO bacterial strains were detected, of which 147 (39.62%) were with nosocomial infection and 224 (60.38%) were without nosocomial infections. The MDRO non-nosocomial infections included 175 strains (47.17%) in community infection and 49 strains (13.12%) in colonization. Carbapenem-resistant Acinetobacter baumannii (52.83%) was the main MDRO strains. Sputum (57.14%) and secretion (35.04%) were main specimens. The top three departments of MDRO nosocomial infection strains were orthopedics (32.65%), ICU (27.89%), neurosurgery (13.61%). ICU [odds ratio (OR)=3.596, 95% confidence interval (CI) (1.124, 11.501), P=0.031], surgical history [OR=2.858, 95%CI (1.061, 7.701), P=0.038], indwelling urinary catheter [OR=3.250, 95%CI (1.025, 10.306), P=0.045], and using three or more antibiotics [OR=4.228, 95%CI (1.488, 12.011), P=0.007] were the independent risk factors of MDRO nosocomial infection.ConclusionEffective infection prevention and control measures should be adopted for the risk factors of MDRO nosocomial infection to reduce the incidence rate of MDRO nosocomial infection.