关键词: 纤维支气管镜；多重耐药菌；医院感染；全程标准化防控；重症监护室

Abstract: Objective: To explore the effect of standardized strategies for the prevention of ICU bronchoscope-associated Multidrug-Resistant Organism (MDRO) in the whole procedure. Methods: A historical control study was adopted. The patients with artificial airway who received bronchofiberscopy in our ICU were divided into 2 groups, control (from January to December 2017) (n=322) or intervention (from February 2018 to January 2019) (n=330) group. Routine bronchoscopy procedure and reprocessing methods were applied in the control group. While standardized strategies for prevention of ICU bronchofiberscopy-associated MDRO in the whole procedure were adopted the intervention group. The number of MDRO isolated from the sputum culture specimens on the 3rd day after bronchocopy, and the colonization/infection rate of MDRO in lower respiratory tract were compared between the two groups. The compliance of hand hygiene and self-protection measures in healthcare professionals, qualified rate of the knowledge regarding the prevention of bronchocopy-related MDRO were compared between the two groups as well. Results: The total isolation rate of MDRO in the intervention group was significantly lower than that in the control group, χ2=99.326, P<0.001; Acinetobacter baumannii (MDR/PDR-AB) was found higher (3.94%) in the control group than the intervention group (0) (χ2=34.816, P<0.001). The infection/colonization rate in the intervention group was lower than the control group, χ2=19.556, P<0.001; χ2=61.566, P<0.001. The compliance of hand hygiene and self-protection measures of healthcare professionals, as well as the qualified rate of the knowledge of prevention bronchocopy-related MDRO in the intervention group were significantly higher than those in the control group (P<0.05). Conclusion: The standardized strategies for the prevention of ICU bronchofiberscopy-associated MDRO in the whole procedure can reduce the incidence of bronchoscope-related MDRO nosocomial infection.

Key words: bronchoscopy; Multidrug-Resistant Organism; nosocomial infection; whole-procedure standardized prevention; Intensive Care Unit