多重耐药菌感染的预防与控制(胡必杰).pptxVIP

24/7/29;;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？;24/7/29;医院感染越来越险恶！;2005-2009年上海XX医院

鲍曼不动杆菌对亚胺培南耐药率变化;耐药菌增加的原因;;24/7/29;2010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;NationalPatientSafetyGoals,HospitalCriticalAccessHospital,2009;美国NationalPatientSafetyGoal;SpreadofMDROsCanBeControlledBy:;FIGHTS;卫生部办公厅关于印发《多重耐药菌医院感染预防与控制技术指南（试行）》的通知（2011.1.17）;WHO抵御细菌耐药的6项政策;必威体育精装版MDROBundle;;超级细菌出现/MDRO泛滥，

我们需要改变什么呢？;24/7/29;酒精擦手的优点;24/7/29;接触隔离的要求;24/7/29;多重耐药菌进行专门标记（德国某医院）;何时开始隔离？何时解除隔离？;24/7/29;ICU减少共用物品;24/7/29;24/7/29;PathogenSurvivalintheEnvironment;

;手频繁接触的物体表面，

是高度危险的！;High-touchequalshigh-risk:

surfacecleaningplushandhygiene

keytoHAIprevention;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;;;病区的基本配置：清洗消毒机;日本尿壶与便盆的消毒;关注频繁手接触物体表面的去污染;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”);;PROPORTIONOFOBJECTSCLEANEDASPARTOFTERMINALROOMCLEANINGIN20ACUTECAREHOSPITALS

;17HOSPITALS;HospitalsEnvironmentalHygieneStudyGroup

36HospitalResults;TERMINALROOMCLEANING

INFECTIONPREVENTION

TARGETS

SinkandFaucets

ToiletSurfaces

ToiletFlushHandle

BedpanCleaner

ToiletAreaHandholds

ToiletAreaDoorKnobsor

PushPlates

BedsideTable

TrayTable

PatientChair

SideRails

RoomDoorKnobs

CallBox

Telephone

BathroomLightSwitches;EvaluatingPatientZoneEnvironmentalHygiene;如何选择表面消毒剂;LowandIntermediateLevelDisinfectants;ExamplesofLowIntermediateLevelDisinfectants;Clean/disinfect:

Onaregularbasis,

Whenspillsoccur,

Whenvisiblysoiled

Followmanufacturers’instructionsforproperuse:

use-dilution,

dwe