A: Multiple Drug Resistant Organism (MDRO) refers to bacteria that are resistant to three or more classes of structurally different (different mechanisms of action) antimicrobial drugs (one or more of each class).
2. How are extensively drug-resistant bacteria defined?
A: Extensive Drug Resistant Organism (XDRO) refers to bacteria that are almost completely resistant to commonly used antimicrobial drugs, Gram-negative bacilli are only susceptible to mucin and tigecycline, and Gram-positive cocci are only susceptible to glycopeptides and linezolid.
3. How are fully resistant bacteria defined?
A: Pan-Drug Resistant Organism (PDRO) refers to the bacteria that are resistant to all the in vitro drug susceptibility tests done so far.
4. Are β-lactams also a "class" of antibacterial drugs?
A: Penicillin, cephalosporins, carbapenems are a separate class.
5. How is resistance to a class of drugs defined?
A: Resistance to any one of a class of antimicrobial drugs is defined as resistance to that class.
6. Does "resistance" in the definition of multi-drug resistant bacteria include natural resistance?
A: The definition of multidrug-resistant bacteria "drug resistance" does not include natural resistance, only refers to acquired resistance.
7. What is the relationship between MDR, XDR and PDR?
A: MDR includes XDR and PDR.
8. What are the common multi-drug resistant bacteria?
A:
①Methicillin-resistant Staphylococcus aureus (MRSA)
②Vancomycin-resistant enterococci (VRE)
③Extra broad-spectrum β-lactamase-producing bacteria (ESBLs)
④Carbapenem-resistant Enterobacteriaceae (CRE), including NDM-1 and KPC-producing Enterobacteriaceae
⑤Carbapenem-resistant Enterobacteriaceae
⑤Enterobacteriaceae, including NDM-1 and KPC-producing Enterobacteriaceae. p>
⑤ Carbapenem-resistant Acinetobacter baumannii (CR-AB)
⑥ Multi-drug-resistant Pseudomonas aeruginosa (MDR-PA)
⑦ Multi-drug-resistant Mycobacterium tuberculosis (MDR-TB)
⑧ Clostridium difficile (CD), etc.
9. Which multidrug-resistant bacteria need to be isolated from contact?
Answer:
①Methicillin-resistant Staphylococcus aureus (MRSA)
②Vancomycin-resistant enterococci (VRE)
③Carbapenem-resistant Enterobacteriaceae (CRE), including NDM-1 and KPC-producing Enterobacteriaceae
④Carbapenem-resistant Acinetobacter baumannii (CR-AB)
⑤Cardiffic acid-resistant bacteria (CD), and so on
9. >
⑤ Clostridium difficile (CD), etc.
10. What are the major risk factors for multi-drug resistant bacterial infections?
Answer:
① Critically ill patients admitted to ICU;
② Long-term hospitalized patients;
③ Previous antimicrobial drug therapy;
④ Intubation or invasive manipulation (urinary catheter, central venous catheter, transnasal gastrointestinal tube, artificial airway+mechanical ventilation);
⑤ Immunosuppressive agent use ......
11. By what means are multidrug-resistant bacteria transmitted?
Answer:
Mainly through contact, such as through:
① contaminated hands
② contaminated medical supplies
③ contaminated medical equipment
12.Prevention and control of hospital infections of multi-drug-resistant bacteria in the focus of the department and the key populations?
A:
The key departments for the prevention and control of hospital-acquired infections with multi-drug-resistant bacteria are: intensive care unit (ICU), neonatal ward, hematology ward, respiratory ward, neurology ward, burns ward, and other key departments;
The key populations are: patients admitted to ICU for a long period of time or patients who have received broad-spectrum antibacterial drug therapy or the effect of antimicrobial drug therapy. Poor patients, especially those with impaired consciousness, poor baseline function at admission (renal insufficiency) with associated underlying diseases (e.g., neurological diseases, diabetes), chemotherapy, corticosteroid therapy, granulocyte deficiency, and patients undergoing invasive operations.
13. What are the prevention and control measures for multi-drug resistant bacteria? How to implement?
Answer:
①Clinical departments must implement standard preventive and contact isolation prevention and control measures according to the results of the detection of drug-resistant bacteria, and the head nurse of the ward is responsible for overseeing the implementation of isolation measures for patients with multi-drug-resistant bacteria in the ward.
② should be multi-drug-resistant bacteria infection and colonization of patients to implement isolation measures, preferred single-room isolation, can also be similar MDRO infected or colonized people placed in the same room. When the isolation room is insufficient, bedside isolation can be considered, and can not be placed in the same room with endotracheal intubation, deep vein indwelling catheter, open wounds or immunosuppressed patients. When there is a large number of infected persons, uninfected persons should be protectively isolated.
③The contact isolation sign is a blue sign, which can be used in the ward, at the bedside or on the patient's wristband. When bedside isolation is implemented, other patients should be seen and cared for first, with MDRO-infected or colonized patients scheduled last.
④The number of medical staff in contact with MDRO-infected or colonized patients should be minimized; it is best to limit the number of patients treated to one doctor and one nurse per shift, and all treatment should be done by them as much as possible, including specimen collection.
⑤ In the implementation of diagnosis and treatment and nursing operation, hand hygiene should be strictly enforced; gloves should be worn when there is a possibility of contact with the patient's wounds, ulcerated surfaces, mucous membranes, bodily fluids, drainage fluids, secretions, and excretions. When there is a possibility of contact with a large area of the patient or by the patient's blood, body fluids, secretions, excretions, splash, should be added to wear isolation gowns and wear protective masks.
6 For non-emergency instruments (such as sphygmomanometers, stethoscopes, thermometers, infusion sets), etc. should be dedicated as much as possible. Other items that cannot be used exclusively by one person (such as wheelchairs and stretchers) should be disinfected with disinfectant wipes or other disinfectants after each use.
⑦The instruments and equipment after contacting the patient (such as filming, electrocardiogram) should be sterilized after completion of the examination.
8 admission of multi-drug-resistant bacteria infection or colonization of the patient's room, its cleaning, disinfection supplies (rags, mops, etc.) should be dedicated to special rooms; frequent contact with the patient's objects, facilities and equipment surfaces, cleaning and disinfection no less than two times a day, by the patient's blood, body fluids contaminated by the patient should be disinfected immediately. Used rags and mops must be disinfected (500mg/L chlorine-containing disinfectant for 30 minutes).
9 strict implementation of the basic principles of the clinical use of antimicrobial drugs, the effective implementation of antibacterial drug classification management, the correct and rational implementation of individualized antibacterial drug delivery program, based on clinical microbiology test results, the rational choice of antibacterial drugs; strict implementation of the relevant provisions of the perioperative antibacterial drug prophylactic use.
⑩Infected persons or carriers should be isolated until symptoms improve, cured, or two consecutive specimens (each interval >24 hours) culture is negative, before lifting the isolation.
14. How to do MDRO monitoring?
Answer:
①Strengthen the monitoring of multi-drug resistant bacteria. Medical institutions should pay attention to the construction of hospital infection management department, and actively carry out the monitoring of common multi-drug resistant bacteria. Multidrug-resistant bacteria infected patients or patients at high risk of colonization should be monitored, relevant specimens collected in a timely manner to send for testing, if necessary, to carry out active screening, in order to timely detection and early diagnosis of multi-drug-resistant bacteria infected patients and patients with colonization.
②Improve the detection ability of clinical microbiology laboratory. Medical institutions should strengthen the capacity of clinical microbiology laboratories to improve their detection of multi-drug resistant bacteria and antimicrobial susceptibility, resistance pattern monitoring level. Clinical microbiology laboratory found multi-drug-resistant bacteria infected patients and colonized patients, should be timely feedback to the hospital infection management department and the relevant clinical departments, in order to take effective treatment and infection control measures.
③Regular publication of the situation. Clinical microbiology laboratory should be at least every six months to the hospital to publish a common clinical isolates of bacterial strains and their drug sensitivity, including the hospital and the key departments of multi-drug-resistant bacteria detected changes and infection trends.
15. Clinical microbiology laboratories should publicize the status of bacterial isolation and drug resistance at least once every six months, at least what information should be included?
Answer:
①Distribution and composition ratio of various clinical isolates in the hospital
②Source and distribution of specimens of clinical isolates in the hospital
③Distribution of common clinical specimens of pathogens
④Antibacterial drug susceptibility analysis of common clinical isolates
⑤Focus on monitoring the distribution of multi-drug resistant bacteria and antimicrobial drug susceptibility analysis
⑤Focus on monitoring the distribution of multi-drug resistant bacteria and antibacterial drug Sensitivity analysis
⑥ Key monitoring of the detection of hospital-acquired pathogens in each key ward
16. The surfaces of objects frequently touched by medical staff and patients What are the surfaces of objects frequently touched? How to deal with it?
Answer: medical personnel and patients frequent contact with the surface of objects (such as cardiac monitors, microinfusion pumps, ventilators and other medical equipment panel or knob surface, stethoscopes, computer keyboards and mice, telephones, patient bed rails and bedside tables, door knobs, faucet switches, etc.), the use of appropriate disinfectant for wiping, disinfection. Disinfection should be done immediately when contaminated by patient's blood and body fluids. When there is an outbreak or suspected outbreak of multi-drug resistant bacteria infection, the frequency of cleaning and disinfection should be increased. Stethoscopes and thermometers are used exclusively.
17. Multidrug-resistant bacteria infected patients or patients with colonization of tableware, clothing, garbage and other how to manage?
① tableware: no need to throw away tableware, should be personalized, do not use other people's tableware or with people *** with tableware;
② clothing: all used clothing should be packaged in the original location, can not be sorted or washed in the hospital area; seriously contaminated clothing should be used to prevent leakage of the bag; collection of clothing workers should use personal protective equipment, such as gloves, etc.; contaminated clothing should be Strictly implement the routine quilt washing and disinfection process.
③Rubbish:
The living waste of patients has not been proved to be necessarily infectious;
Medical waste generated in the process of diagnosis and treatment of patients infected with multi-drug-resistant bacteria or colonized patients should be disposed of and managed in accordance with the relevant regulations on medical waste.
18. What is multi-drug resistant bacteria colonization? Is treatment required? Is it necessary to implement contact isolation?
A: MDRO colonization refers to the isolation of MDRO in clinical microbiology samples sent by patients, but there are no clinical signs of infection, such as fever, abscesses, etc., to rule out contamination, that is, it is determined to be colonization. Colonization can be found in the respiratory tract, skin, open wounds, etc. MDRO colonization does not require treatment, but contact isolation precautionary control measures should be implemented.
19. What is a multidrug-resistant bacterial infection?
A: Multidrug-resistant bacterial infections include infections of various systems, such as the respiratory system, the urinary system, the blood system, surgical sites, etc., and clinical microbiology samples from the corresponding sites isolate MDRO and meet the clinical diagnosis of infection at the site.