Lin Nien-Tsung
Institute of Microbiology, Immunology and Biochemistry, Tzu Chi University, ROC.
Hu Li Za Zhi. 2011 Aug;58(4):5-10.
Infections caused by antibiotic-resistant bacteria, especially multidrug-resistant strains (MDR) that cause difficulties in clinical treatment, have long been a problem of global concern. Drug-resistant strains of common nosocomial infections in Taiwan include Gram-positive coccal methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, and Gram-negative bacilli such as carbapenem-resistant Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae, among others. About 10 to 20% of Gram-negative bacteria that encode extended-spectrum β-lactamases are resistant to cephalosporin, a third generation antibiotic, and the fluoroquinolone-resistance rate has continued to increase in recent years. Despite the high mortality rate in patients with infections caused by MDR, the problem is still solvable by blocking or reducing MDR dissemination in addition to proper antibiotics use. Hand hygiene is the simplest, most effective measure for preventing nosocomial infections. However, healthcare workers' adherence to recommended hand hygiene practices is unacceptably low worldwide, making the promotion of hand hygiene a major challenge for infection control experts. Therefore, as a first step of preventing the spread of MDR bacteria, knowledge of hand hygiene and adherence to hand hygiene practices must be required of healthcare workers. Such should help reduce nosocomial infections significantly and upgrade healthcare quality.
由抗生素耐药菌引起的感染，尤其是导致临床治疗困难的多重耐药菌株（MDR），长期以来一直是全球关注的问题。台湾常见医院感染的耐药菌株包括革兰氏阳性球菌中的耐甲氧西林金黄色葡萄球菌和耐万古霉素肠球菌，以及革兰氏阴性杆菌，如耐碳青霉烯鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌等。约10%至20%编码超广谱β-内酰胺酶的革兰氏阴性菌对第三代抗生素头孢菌素耐药，近年来氟喹诺酮耐药率持续上升。尽管多重耐药菌感染患者的死亡率很高，但除了合理使用抗生素外，通过阻断或减少多重耐药菌的传播，这个问题仍然是可以解决的。手部卫生是预防医院感染最简单、最有效的措施。然而，在全球范围内，医护人员对推荐的手部卫生规范的依从性低得令人无法接受，这使得推广手部卫生成为感染控制专家面临的一项重大挑战。因此，作为预防多重耐药菌传播的第一步，必须要求医护人员掌握手部卫生知识并遵守手部卫生规范。这应该有助于显著减少医院感染并提升医疗质量。
