分子分型在医院感染控制中的作用.ppt

指标*thetotalnumberofnosocomialinfectionsper1,000patientdays每千住院日医院感染数thenumberofpatientswithnosocomialinfectionsper100patientdischarges每100出院病人医院感染病人数(percentageofpatientswithnosocomialinfection)（医院感染病人百分比）感染控制工作小组成员：*Weformedapermanent,integratedinfectioncontrolandpreventionprogramthatfullyincorporatesHacekDMetal.AmJClinPathol1999;111:647-54.infectioncontrolpersonnel,infectiousdiseasepersonnel,pharmacypersonnel,clinicalmicrobiologypersonnelintoasingleworkinggrouptominimizehospitalinfections.感染控制感染性疾病药学临床微生物reviewofmicrobiologyreportsreviewofpatientsmedicalrecords,directobservationofmedicalandnursingpractice,activesurveillanceofrectalculturesofpatientsinnursingunitsforhigh-riskpatients,evaluationofsuspectednosocomialinfectionsreportedbyhealth-careproviders.查阅微生物报告查阅病史记录对医护人员操作的直接观察高危病人直肠培养的动态连续观察对上报的可疑医院感染的评估鉴定由三位专职感染控制人员对资料进行汇总分析，并制定出相应控制措施，并在医院感染控制和预防部门主管的指导下实施。Twointerventions：*Twointerventions：amoleculartypinglaboratoryaweeklyplanningmeetinginfectioncontroldiagnosticmedicalmicrobiology(molecularepidemiology)Pharmacyandinfectiousdiseases两个主要的干预措施：分子分型周会包括以下方面的代表：感染控制微生物诊断（分子流行病学）药学感染性疾病*周会内容：医院感染动向（短期、长期）感染控制专职人员和微生物实验室的工作决定需要做的调整需分型的病原体与主管讨论决定weeklymeetings：theongoingshort-andlong-termtrendsinnosocomialinfectionswithinthecenteractivitiesoftheinfectioncontrolprofessionalsandmicrobiologylaboratorypersonnel;anyneededchangesweredetermined.Theorganizationalstructureforselectingmicrobesfortypingwassharedbythemedicaldirectorsofinfectioncontrolandclinicalmicrobiology*routinelygenomicallytyped：VREPeriodicroutinetyping：fluoroquinolone-resistantP.aeruginosa,methicillin-resistantStaphylococcusaureus(MRSA),Enterobactercloacae,ClostridiumdifficileAdditionalorganismsfortyping：selectedthroughsurveillan