發(fā)布時間：2018-05-07 16:21

  本文選題：計算機 + 電話��； 參考：《重慶醫(yī)科大學》2010年碩士論文

【摘要】： 目的: 探討重癥監(jiān)護室信息系統(tǒng)(計算機鍵盤鼠標與內(nèi)部固定電話的控制按鍵和電話聽筒)表面以及工作人員雙手表面病原菌的分布和耐藥情況,為有效防治院內(nèi)感染提供參考。 方法: 2009年9月14日～2009年9月20日在重慶醫(yī)科大學附屬兒童醫(yī)院重癥監(jiān)護室,對其使用的所有計算機鍵盤鼠標(9臺)與內(nèi)部固定電話的控制按鍵和電話聽筒(3部)以及每天隨機抽取的13名工作人員的雙手表面連續(xù)取樣7天。采用常規(guī)方法對各類標本進行分離培養(yǎng),并就病原菌分布和耐藥情況進行分析。 結果: 1、175例標本中,有21例標本分離培養(yǎng)出病原菌,陽性率12.0%;其中10例(47.6%)來自工作人員雙手,7例(33.3%)來自計算機鍵盤鼠標,4例(19.1%)來自內(nèi)部固定電話的控制按鍵和電話聽筒。 2、共分離培養(yǎng)出病原菌3種,均為革蘭氏陽性菌。溶血性葡萄球菌19株(90.4%)、金黃色葡萄球菌1株(4.8%)、木糖葡萄球菌1株(4.8%)。溶血葡萄球菌占檢出病原菌的首位,在計算機鍵盤鼠標,內(nèi)部固定電話和工作人員雙手上均有發(fā)現(xiàn)。金黃色葡萄球菌來自計算機鍵盤鼠標。木糖葡萄球菌來自工作人員雙手。 3、19株溶血葡萄球菌中耐甲氧西林溶血葡萄球菌檢出率為68.4%(13/19)。耐甲氧西林的溶血葡萄球菌對20種抗生素的耐藥率明顯高于甲氧西林敏感的溶血葡萄球菌。 4、藥敏結果顯示病原菌對萬古霉素、利奈唑胺、替考拉寧、利福平、四環(huán)素、呋喃妥因、阿米卡星、奎奴普汀/達福普汀全部敏感。甲氧芐啶和哌拉西林的耐藥率也較低,均為14.3%。20種抗生素耐藥率最高的是氨芐青霉素,達71.4%。其他抗生素也有較高的耐藥率。 5、本研究中ICU與所在醫(yī)院的2009年全院常見革蘭陽性球菌藥敏結果比較顯示:ICU溶血葡萄球菌耐藥率和MRS的檢出率均低于全院水平。 結論: 1、重癥監(jiān)護室的信息系統(tǒng)的污染情況值得關注,它們可以作為引起院內(nèi)交叉感染的跨載體。應定期對其清潔和消毒,從而把院內(nèi)感染的危險因素降到最低。 2、科室工作人員應當認識到他們雙手傳播的細菌可以導致重癥監(jiān)護室內(nèi)發(fā)生院內(nèi)感染。每個工作人員在進行操作前后和使用信息系統(tǒng)之前都要進行洗手或是消毒或者使用手套隔離。
[Abstract]:Objective: To investigate the distribution and drug resistance of pathogens on the surface of the information system of intensive care unit (computer keyboard mouse and internal fixed telephone control keys and telephone handsets) as well as on the surface of staff hands in order to provide a reference for the effective prevention and treatment of nosocomial infection. Methods: From September 14, 2009 to September 20, 2009 in the intensive Care Unit of Children's Hospital affiliated to Chongqing Medical University. For all the computer keyboards and mice used, 9 units) and 3 control buttons and telephone handsets for internal fixed phones) and 13 staff members randomly sampled daily for 7 consecutive days on the surface of the hands. All kinds of specimens were isolated and cultured by routine method, and the distribution and drug resistance of pathogens were analyzed. Results: Of the 1175 specimens, 21 samples were isolated and cultured, with a positive rate of 12.0, among which 10 cases (47.6) came from the hands of the staff, 7 cases (33.3) from the computer keyboard, mouse and mouse (4 cases) and 19.1) from the control keys and telephone handsets of the internal fixed telephone. 2. Three kinds of pathogenic bacteria were isolated and cultured, all of them were Gram-positive bacteria. There were 19 strains of Staphylococcus haemolyticus, 1 strain of Staphylococcus aureus, 1 strain of Staphylococcus aureus, and 1 strain of Staphylococcus xylose. Staphylococcus haemolyticus was the most common pathogen found in computer keyboard mouse internal fixed telephone and staff hands. Staphylococcus aureus comes from a computer keyboard and mouse. Staphylococcus xylostaphylococcus comes from the hands of the staff. The detection rate of methicillin-resistant Staphylococcus haemolyticus in 19 strains of Staphylococcus haemolyticus was 68.4 / 19. The resistance rate of methicillin-resistant staphylococcus haemolyticus to 20 antibiotics was significantly higher than that of methicillin-sensitive Staphylococcus haemolyticus. 4. The results of drug sensitivity showed that the pathogens were all sensitive to vancomycin, linazolamine, tetracycline, quinapine / difampicin. The resistance rates of trimethoprim and piperacillin were also low, which were 14.3.20 antibiotics and the highest resistance rate was ampicillin, which reached 71.4. Other antibiotics also have high rates of drug resistance. 5. In this study, the results of drug sensitivity of common Gram-positive cocci in our hospital in 2009 showed that the rate of drug resistance and the detection rate of MRS in ICU were lower than those in the whole hospital. Conclusion: 1. The contamination of information system in ICU is worthy of attention. They can be used as cross-carriers to cause cross-infection in hospital. They should be cleaned and disinfected regularly to minimize the risk of nosocomial infection. 2. Staff should recognize that the bacteria transmitted by their hands can cause nosocomial infections in intensive care units. Before and after operation and before using the information system, each staff member should wash their hands or sterilize or use gloves to isolate them.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R187

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