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目的探讨多学科协作(multi-disciplinary team,MDT)在多重耐药菌(multidrug-resistant organism,MDRO)医院感染中的作用。方法 2012年1月—2014年1月以318名医生为研究对象,对医生给予MDT干预,干预前(2012年1—12月)对4 765例患者进行耐药性检测,干预后(2013年1月—2014年1月)对4 585例患者进行耐药性检测,对所有患者的临床资料进行整理、分析。率的比较采用χ2检验,检验水准α=0.05,P<0.05为差异有统计学意义。结果医务人员手卫生依从性由干预前45.3%升高至干预后83.6%(χ2=103.64,P<0.05);发现MDRO后接触隔离执行率由63.0%升高至87.5%(χ2=5.24,P<0.05);干预前送检率由57.4%升高至干预后61.2%(χ2=15.99,P<0.05)。干预前MDRO菌株检出率4.94%,干预后检出率1.85%,比较差异有统计学意义(χ2=78.92,P<0.05)。由MDRO引起的院内感染,干预前占68.1%,干预后占46.2%,比较差异有统计学意义(χ2=7.71,P<0.05)。结论 MDT可有效提高MDRO院内防控措施依从性,降低院内感染率。
Objective To investigate the role of multi-disciplinary team (MDT) in hospital infection of multidrug-resistant organism (MDRO). Methods From January 2012 to January 2014, MDT interventions were performed on 318 physicians in our hospital, and 4 765 patients were tested for drug resistance before intervention (January-December 2012). After intervention (2013 Jan. - Jan. 2014) tested the drug resistance of 4 585 patients and sorted out and analyzed the clinical data of all patients. Rate comparison using χ2 test, test level α = 0.05, P <0.05 for the difference was statistically significant. Results The hand hygiene compliance of medical staff increased from 45.3% before intervention to 83.6% after intervention (χ2 = 103.64, P <0.05). The implementation rate of contact isolation after MDRO increased from 63.0% to 87.5% (χ2 = 5.24, P <0.05). The pre-intervention rate increased from 57.4% to 61.2% after intervention (χ2 = 15.99, P <0.05). The detection rate of MDRO strains before intervention was 4.94%, and the detection rate was 1.85% after intervention, the difference was statistically significant (χ2 = 78.92, P <0.05). The nosocomial infection caused by MDRO accounted for 68.1% before intervention and 46.2% after intervention, the difference was statistically significant (χ2 = 7.71, P <0.05). Conclusion MDT can effectively improve compliance with prevention and control measures in hospital and reduce the nosocomial infection rate.