中文摘要：

目的采取信息化手段,对某三级甲等综合教学医院外科病区多药耐药菌患者及时有效进行干预,评价失访率与隔离措施依从率,探讨多药耐药菌精准化管理。方法通过医院感染实时监控系统,及时有效追踪2015年1-12月外科住院患者检出的目标监测多药耐药菌,按照医院信息化流程进行精准化管理,包括：通过LIS系统备注栏告知临床、医院感染实时监控系统推送干预信息、结合现场督导评价隔离措施依从率等方式进行管理。结果 2015年共396例患者检出多药耐药菌,均采取LIS系统备注栏提示及医院感染实时监控系统推送干预信息,现场督导303例患者,失访率为23.50%;失访较高科室主要为烧伤科35.70%和ICU31.90%;结合同期患者住院总日数,外科病区多药耐药菌检出率为0.94‰,耐碳青霉烯类鲍氏不动杆菌检出率为0.39‰,耐甲氧西林金黄色葡萄球菌检出率为0.37‰,多药耐药铜绿假单胞菌检出率为0.10‰,在外科病区中ICU多药耐药菌检出率最高为21.02‰;对303例多药耐药菌患者现场督导隔离措施执行情况,开隔离医嘱依从率为95.00%,更换隔离床头卡的依从率为94.40%,床旁放置快速手消毒剂依从率为96.70%,清洁工对多药耐药菌患者的知晓率为94.10%,胃肠外科开隔离医嘱依从率最低为87.50%。结论通过信息化干预手段,精准化管理多药耐药菌,这对多药耐药菌预防控制有着至关重要意义。

英文摘要：

OBJECTIVE To take effective interventions to patients with multidrug-resistant organisms（MDROs）in surgical wards of a tertiary first-class general teaching hospital by using information technology means,evaluate the dropout rate and compliance of isolation measures,and explore the precise management of MDROs.METHODS By means of real-time monitoring system of nosocomial infection,the targeted MDROs that were isolated from the patients who were hospitalized in the surgery department from Jan 2015 to Dec 2015 were effectively traced,and the precise management was carried out according to the hospital information process,including informing the hospital through LIS system note,pushing intervention information through real-time monitoring and control system,and evaluating the compliance of isolation measures in combination with onsite supervision.RESULTS The MDROs were detected in 396 patients in 2015,the intervention information was pushed for all of the patients by means of the LIS system note and the real-time monitoring system,303 patients received the onsite supervision,the dropout rate was 23.50%,the dropout rate was relatively high in the burn department（35.70%）or the ICU（31.90%）.Combined with the total length of hospital stay,the isolation rate of MDROs was 0.94‰in the surgical wards,the isolation rate of carbapenem-resistant Acinetobacter baumannii was 0.39‰,the isolation rate of methicillin-resistant Staphylococcus aureus was 0.37‰,and the isolation rate of multidrug-resistant Pseudomonas aeruginosa was 0.10‰.Among the surgical wards,the isolation rate of the MDROs was highest in the ICU（21.02‰）.With regard to the isolation measures that were taken for the 303 patients by the onsite supervision,the compliance rate of prescribing isolation was 95.00%,the compliance rate of replacing isolation card was 94.40%,the compliance rate of placing ABHR bedside was 96.70%,the rate of the cleaning staff＇s awareness of MDROs patients was 94.10%,and the compliance rate of prescribing isolation