多重耐药菌感染的预防与控制课件.ppt

*;对于超级细菌/多重耐药菌，

要防被忽悠，更要防止麻木！;耐药菌的难题，远不止NDM-1！;什么是多重耐药菌？;*;医院感染越来越险恶！;;正确认识接触预防

有效控制多重耐药菌MDRO;耐药菌增加的原因;AntimicrobialResistance恶性循环;*;2021年上海某医院ICU中22例病人痰培养检出

多重耐药菌－鲍曼不动杆菌，PFGE结果;;;最新MDROBundle;;超级细菌出现/MDRO泛滥，

我们需要改变什么呢？;*;酒精擦手的优点;*;接触隔离的要求;*;何时开始隔离？何时解除隔离？;*;ICU减少共用物品;*;*;手频繁接触的物体外表，

是高度危险的！;ICU中，容易被污染的物表;ICU环境中耐药鲍曼不动杆菌污染严重;;ManualCleaning;;;病区的根本配置：清洗消毒机;日本尿壶与便盆的消毒;关注频繁手接触物体外表的去污染;MICROFIBER

The“cleaner〞cleaningsystem;关东病院设备科-保养与维修;HowCanWeEvaluateEnvironmentalCleaning;TESTINGOFSURFACES;ATPbioluminescence;ATPispresentinblood,skincells,otherbodilyfluidsandmicrobes.

ATP存在于血液，皮肤细胞，

其它体液和微生物中。;DazoSolution

(Initiallycalled“GOO〞);;COMPUTERSCABLES;;PROPORTIONOFOBJECTSCLEANEDASPARTOFTERMINALROOMCLEANINGIN20ACUTECAREHOSPITALS

;17HOSPITALS;HospitalsEnvironmentalHygieneStudyGroup

36HospitalResults;TERMINALROOMCLEANING

INFECTIONPREVENTION

TARGETS

SinkandFaucets

ToiletSurfaces

ToiletFlushHandle

BedpanCleaner

ToiletAreaHandholds

ToiletAreaDoorKnobsor

PushPlates

BedsideTable

TrayTable

PatientChair

SideRails

RoomDoorKnobs

CallBox

Telephone

BathroomLightSwitches;EvaluatingPatientZoneEnvironmentalHygiene;如何选择外表消毒剂;LowandIntermediateLevelDisinfectants;ExamplesofLowIntermediateLevelDisinfectants;Clean/disinfect:

Onaregularbasis,

Whenspillsoccur,

Whenvisiblysoiled

Followmanufacturers’instructionsforproperuse:

use-dilution,

dwelltime,

materialcompatibility,

storage,

shelf-life.

1:10BleachrecommendedforC.difficile;*;ReservoirforSpreadofAntibioticResistantPathogens;*;Outcomes:ActiveSurveillanceControlsMRSABSIs;美国20个州立法：

住院病人主动筛查、隔离MRSA和VRE;进行主动筛查的人群;*;*;ICU需要重点防范的医院感染;*;*;*;洗必泰对于鲍曼不动杆菌的控制;Impactof4%Chlorhexidine(CHG)Whole-BodyWashingonMultidrug-resistantAcinetobacterba