我国医疗机构多重耐药菌防控的管理要求与实践
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摘要
随着广谱抗菌药物的广泛应用,细菌耐药情况呈现逐年增长的趋势,多重耐药菌的出现增加了临床抗感染治疗和医院感染防控的难度。减慢耐药菌发展及防止耐药菌的传播已在国际上引起广泛关注,成为广大临床医护人员及各级管理部门面临的严峻挑战。我国政府和卫生行政部门高度重视多重耐药菌防控工作,从2004年起,国家层面已陆续发布抗菌药物管理及多重耐药菌防控相关文件、指南、部门规章等20余项,对多重耐药菌防控工作提出明确要求。落实多重耐药菌预防和控制措施是切断传播途径,防止医院内传播的关键,临床一线医护人员应当在日常工作中以高度的责任心,严格执行相关防控措施。
With the increasing of antibiotics, drug resistance of organism is increasing, the emergence of MultidrugResistant Organism(MDRO) has greatly increased the difficulty of clinical treatment of infections and prevention and control of Health-care Associated Infection(HAI). Now the international community has focused on slowing down the development of MDRO and preventing the dissemination and MDRO is a serious challenge for clinical staff and management departments. The government and health administration think highly of the prevention and control of MDRO. Since 2004, more than 20 documents, guidelines and regulations on the management of antimicrobial agents and the prevention and control of MDRO have been issued on the national level, which make specific requirements for the prevention and control of MDRO. Implementing interventions to prevent MDRO is the key to cut off the transmission and prevent the spread in hospitals. Clinical staffs should strictly implement the relevant prevention and control measures with a high sense of responsibility in their daily work.
With the increasing of antibiotics, drug resistance of organism is increasing, the emergence of MultidrugResistant Organism(MDRO) has greatly increased the difficulty of clinical treatment of infections and prevention and control of Health-care Associated Infection(HAI). Now the international community has focused on slowing down the development of MDRO and preventing the dissemination and MDRO is a serious challenge for clinical staff and management departments. The government and health administration think highly of the prevention and control of MDRO. Since 2004, more than 20 documents, guidelines and regulations on the management of antimicrobial agents and the prevention and control of MDRO have been issued on the national level, which make specific requirements for the prevention and control of MDRO. Implementing interventions to prevent MDRO is the key to cut off the transmission and prevent the spread in hospitals. Clinical staffs should strictly implement the relevant prevention and control measures with a high sense of responsibility in their daily work.
引文
[1]蔡虻,刘聚源.多重耐药菌医院感染防控策略与思考.中国护理管理,2018,18(12):1590-1594.Cai M, Liu JY. Thinking on the strategy on prevention and control of Multidrug-Resistant Organism healthcare-associated infection. Chinese Nursing Management, 2018,18(12):1590-1594.
[2]孟秀娟,吴安华.如何应对多重耐药菌医院感染的严峻挑战.中国感染控制杂志,2019,18(3):185-192.Meng XJ, Wu AH. How to deal with severe challenge of healthcare-associated infection due to multidrug-resistant organisms. Chin J Infec Contl,2019,18(3):185-192.
[3] Hur EY, Jin YJ, Jin TX, et al. Development and evaluation of the automatedrisk assessment system for multidrug-resistant organisms(auto RAS-MDRO). J Hosp Infect, 2018,98(2):202-211.
[4] Kumarasamy KK, Toleman MA, Walsh TR,et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK:a molecular, biological, and epidemiological study.Lancet Infect Dis, 2010,10(9):597-602.
[5] European Centre for Disease Prevention and Control. Rapid risk assessment:carbapenemresistant enterobacteriaceae.(2016). https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/carbapenemresistantenterobacteriace ae-risk-assessmentapril-2016.pdf.
[6] Zhang Y, Chen XL, Huang AW, et al. Mortality attributable to carbapenem-resistant Pseudomonas aeruginosa bacteremia:a meta analysis of cohort studies. Emerg Microbes Infect, 2016(5):e27.
[7] Hampton T. Report reveals scope of US antibiotic resistance threat. JAMA, 2013,310(16):1661-1663.
[8] Center for Disease Control and Prevention.National strategy for combating antibiotic resistance. Washinton:The White House,2014.
[9] Levy SB. Multidrug resistance--a sign of the times. N Engl J Med, 1998, 338(19):1376-1378.
[2]孟秀娟,吴安华.如何应对多重耐药菌医院感染的严峻挑战.中国感染控制杂志,2019,18(3):185-192.Meng XJ, Wu AH. How to deal with severe challenge of healthcare-associated infection due to multidrug-resistant organisms. Chin J Infec Contl,2019,18(3):185-192.
[3] Hur EY, Jin YJ, Jin TX, et al. Development and evaluation of the automatedrisk assessment system for multidrug-resistant organisms(auto RAS-MDRO). J Hosp Infect, 2018,98(2):202-211.
[4] Kumarasamy KK, Toleman MA, Walsh TR,et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK:a molecular, biological, and epidemiological study.Lancet Infect Dis, 2010,10(9):597-602.
[5] European Centre for Disease Prevention and Control. Rapid risk assessment:carbapenemresistant enterobacteriaceae.(2016). https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/carbapenemresistantenterobacteriace ae-risk-assessmentapril-2016.pdf.
[6] Zhang Y, Chen XL, Huang AW, et al. Mortality attributable to carbapenem-resistant Pseudomonas aeruginosa bacteremia:a meta analysis of cohort studies. Emerg Microbes Infect, 2016(5):e27.
[7] Hampton T. Report reveals scope of US antibiotic resistance threat. JAMA, 2013,310(16):1661-1663.
[8] Center for Disease Control and Prevention.National strategy for combating antibiotic resistance. Washinton:The White House,2014.
[9] Levy SB. Multidrug resistance--a sign of the times. N Engl J Med, 1998, 338(19):1376-1378.