Research progress on hospital infection prevention and control of multidrug-resistant organisms

doi:10.19982/j.issn.1000-6621.20250163

Abstract

Abstract:

Hospital-acquired infections caused by multidrug-resistant organisms (MDROs) have become a major challenge in the global public health field. Infections caused by MDROs are complex and difficult to treat, posing a serious threat to medical quality and patient safety. This article systematically reviews the relevant literature in recent years and summarizes the research progress in this field from multiple aspects, including epidemiological characteristics, risk factors, transmission routes, prevention and control strategies, and challenges in prevention and control. The aim is to provide comprehensive references for clinical workers in the prevention and control of MDROs hospital-acquired infections, so as to reduce the incidence of MDROs infections, improve patient prognosis, and promote the continuous optimization and development of prevention and control work.

Key words: Drug resistance, multiple, bacterial, Hospitals, Infection control, Review literature as topic

CLC Number:

R184

Wang Lin, Qu Yan. Research progress on hospital infection prevention and control of multidrug-resistant organisms[J]. Chinese Journal of Antituberculosis, 2025, 47(9): 1196-1203. doi: 10.19982/j.issn.1000-6621.20250163

References 47

[1]	黄勋, 邓子德, 倪语星, 等. 多重耐药菌医院感染预防与控制中国专家共识. 中国感染控制杂志, 2015, 14(1): 1-9. doi:10.3969/j.issn.1671-9638.2015.01.001.
[2]	陈美恋, 贾会学, 李六亿. 多重耐药菌感染监测及防控现状综述. 中国感染控制杂志, 2015, 14(8):571-576. doi:10.3969/j.issn.1671-9638.2015.08.015.
[3]	乔甫, 黄文治, 宗志勇. 多重耐药菌感染防控的意义与发展趋势. 中国护理管理, 2019, 19(8):1129-1134. doi:10.3969/j.issn.1672-1756.2019.08.003.
[4]	Zhen X, Lundborg CS, Sun X, et al. Economic burden of antibiotic resistance in ESKAPE organisms:a systematic review. Antimicrob Resist Infect Control, 2019, 8(1): 137. doi:10.1186/s13756-019-0590-7.
[5]	Geffers C, Gastmeier P. Nosocomial infections and multidrug-resistant organisms in Germany: epidemiological data from KISS (the Hospital Infection Surveillance System). Dtsch Arztebl Int, 2011, 108(6): 87-93. doi:10.3238/arztebl.2011.0087. pmid: 21373275
[6]	Breijyeh Z, Jubeh B, Karaman R. Resistance of Gram-negative bacteria to current antibacterial agents and approaches to resolve it. Molecules, 2020, 25(6): 1340. doi:10.3390/molecules25061340.
[7]	Johnston BL, Bryce E. Hospital infection control strategies for vancomycin-resistant Enterococcus, methicillin-resistant Staphylococcus aureus and Clostridium difficile. CMAJ, 2009, 180(6): 627-631. doi:10.1503/cmaj.080195. pmid: 19289807
[8]	Lucet JC, Grenet K, Armand-Lefevre L, et al. High prevalence of carriage of methicillin-resistant Staphylococcus aureus at hospital admission in elderly patients: implications for infection control strategies. Infect Control Hosp Epidemiol, 2005, 26(2): 121-126. doi:10.1086/502514.
[9]	Luo Q, Lu P, Chen Y, et al. ESKAPE in China: epidemiology and characteristics of antibiotic resistance. Emerg Microbes Infect, 2024, 13(1): 2317915. doi:10.1080/22221751.2024.2317915.
[10]	袁晓宁. 多重耐药菌的形成机理及其防控措施研究进展. 中国消毒学杂志, 2016, 33(8): 792-796. doi:10.11726/j.issn.1001-7658.2016.08.025.
[11]	Saliba R, Zahar JR, Dabar G, et al. Limiting the Spread of Multidrug-Resistant Bacteria in Low-to-Middle-Income Countries: One Size Does Not Fit All. Pathogens, 2023, 12(1): 144. doi:10.3390/pathogens12010144.
[12]	杨启文, 吴安华, 胡必杰, 等. 临床重要耐药菌感染传播防控策略专家共识. 中国感染控制杂志, 2021, 20(1): 1-14. doi:10.12138/j.issn.1671-9638.20218124.
[13]	全国细菌耐药监测网. 2021年全国细菌耐药监测报告(简要版)[R/OL]. (2023-01-10)[2025-04-20]. https://www.carss.cn/Report/Details?aId=862.
[14]	全国细菌耐药监测网. 2023年全国细菌耐药监测报告(简要版)[R/OL]. (2024-11-18) [2025-04-20]. https://www.carss.cn/Report/Details?aId=978.
[15]	葛芳, 黄丽晴, 毛美琴. 多重耐药菌感染的危险因素与防控措施. 中国消毒学杂志, 2017, 34(3): 292-294. doi:10.11726/j.issn.1001-7658.2017.03.035.
[16]	周芳, 董亚琳. ICU多重耐药菌医院感染的危险因素分析. 中国药房, 2017, 28(14): 1916-1920. doi:10.6039/j.issn.1001-0408.2017.14.12.
[17]	Woz'niak A, Janc J, Łysenko L, et al. How to Defeat Multidrug-Resistant Bacteria in Intensive Care Units. A Lesson from the COVID-19 Pandemic. Prevention, Reservoirs, and Implications for Clinical Practice. Int J Med Sci, 2024, 21(3): 530-539. doi:10.7150/ijms.88519. pmid: 38250609
[18]	李六亿. 标准预防——防控多重耐药菌感染的基本策略. 中国护理管理, 2019, 19(8): 1121-1125. doi:10.3969/j.issn.1672-1756.2019.08.001.
[19]	李颖, 许文, 戈伟, 等. 提高多重耐药菌防控措施执行力对降低多重耐药菌医院感染的影响. 中国感染控制杂志, 2017, 16(2): 126-129. doi:10.3969/j.issn.1671-9638.2017.02.006.
[20]	D’Agata EM, Horn MA, Ruan S, et al. Efficacy of infection control interventions in reducing the spread of multidrug-resistant organisms in the hospital setting. PLoS One, 2012, 7(2): e30170. doi:10.1371/journal.pone.0030170.
[21]	刘璐璐, 牟作峰, 杨会香, 等. 重症监护病房多重耐药菌感染的现状及综合干预对策. 护理研究, 2015, 29(2): 144-147. doi:10.3969/j.issn.10096493.2015.02.006.
[22]	谭善娟, 李玲, 邱蔓, 等. 多学科协作联合集束化管理对ICU多重耐药菌感染预防的效果. 中国感染控制杂志, 2018, 17(2): 156-159. doi:10.3969/j.issn.1671-9638.2018.02.014.
[23]	黄菊, 杨坚娥, 黄少君. FMEA风险评估法在ICU多重耐药菌医院感染防控中的应用. 中国感染控制杂志, 2019, 18(11): 1079-1083. doi:10.12138/j.issn.1671-9638.20194419.
[24]	曲慧, 孙海宏, 王伟. 失效模式与效应分析在降低ICU多重耐药菌感染中的应用效果. 中国感染控制杂志, 2022, 21(1):72-79. doi:10.12138/j.issn.1671-9638.20221336.
[25]	孟秀娟, 吴安华. 如何应对多重耐药菌医院感染的严峻挑战. 中国感染控制杂志, 2019, 18(3):185-192. doi:10.12138/j.issn.1671-9638.20194529.
[26]	Centers for Disease Control and Prevention. Facility guidance for control of carbapenem-resistant Enterobacteriaceae (CRE)-November 2015 update-CRE Toolkit[EB/OL]. [2025-04-20]. https://www.cdc.gov/hai/pdfs/cre/CREguidance-508.pdf.
[27]	王力红, 赵霞. 我国医疗机构多重耐药菌防控的管理要求与实践. 中国护理管理, 2019, 19(8):1135-1138. doi:10.3969/j.issn.1672-1756.2019.08.004.
[28]	侯媛, 陈晓霞, 王柄璋, 等. 住院病人多重耐药菌感染控制管理风险预警指标体系的构建. 护理研究, 2024, 38(10):1693-1702. doi:10.12102/j.issn.1009-6493.2024.10.001.
[29]	Hur EY, Jin YJ, Jin TX, et al. Development and evaluation of the automated risk assessment system for multidrug-resistant organisms (autoRAS-MDRO). J Hosp Infect, 2018, 98(2):202-211. doi:10.1016/j.jhin.2017.08.004. pmid: 28807836
[30]	吴菠, 鄢雨英, 宋丽莹, 等. 多重耐药菌感染信息管理系统的构建及应用研究. 中华护理杂志, 2024, 59(16):1942-1947. doi:10.3761/j.issn.0254-1769.2024.16.003.
[31]	Ji B, Ye W. Prevention and control of hospital-acquired infections with multidrug-resistant organism: A review. Medicine (Baltimore), 2024, 103(4): e37018. doi:10.1097/MD.0000000000037018.
[32]	黄燕华, 姚美华, 曹利华, 等. 基于信息化集成平台的多重耐药菌医院感染集束化管理策略实践及其成效. 中华医院感染学杂志, 2025, 35(1): 115-120. doi:10.11816/cn.ni.2025-240410.
[33]	黄海欣, 范舒雅, 赵倍莹, 等. 2017—2022年吉林省某综合医院多重耐药菌监测报告分析. 智慧健康, 2023, 9(28): 10-13. doi:10.19335/j.cnki.2096-1219.2023.28.003.
[34]	段友红, 张梦兰, 夏新红, 等. 蚌埠地区某三级医院2015—2017年多重耐药菌监测分析. 安徽医药, 2019, 23(2):399-402. doi:10.3969/j.issn.1009-6469.2019.02.052.
[35]	Korczak D, Schöffmann C. Medical and health economic evalua-tion of prevention- and control measures related to MRSA infections or -colonisations at hospitals. GMS Health Technol Assess, 2010, 6: Doc04. doi:10.3205/hta000082.
[36]	谢首佳, 王美玉, 潘建平. 多学科协作在多重耐药菌医院感染防控中的实践与效果. 中国感染控制杂志, 2017, 16(8): 741-744. doi:10.3969/j.issn.1671-9638.2017.08.012.
[37]	孙丽琴, 刘甲野, 王辉, 等. 多重耐药菌耐药机制及治疗概述. 中国临床新医学, 2022, 15(10):921-927. doi:10.3969/j.issn.1674-3806.2022.10.06.
[38]	Sy CL, Chen PY, Cheng CW, et al. Recommendations and guidelines for the treatment of infections due to multidrug resistant organisms. J Microbiol Immunol Infect, 2022, 55(3):359-386. doi:10.1016/j.jmii.2022.02.001.
[39]	马兴换. 新型广谱四环素类抗生素依拉环素的研究. 国外医药(抗生素分册), 2025, 46(1): 39-44. doi:10.3969/j.issn.1001-8751.2025.01.007.
[40]	吕毅华, 李昕, 刘周, 等. 镓在抗菌方面的研究进展. 中国抗生素杂志, 2018, 43(4): 394-400. doi:10.3969/j.issn.1001-8689.2018.04.005.
[41]	倪冬梅, 葛姝囡, 王蕾, 等. 信息化管理在多重耐药菌防控中的应用及效果分析. 中华医院管理杂志, 2019, 35(z1): 74-77. doi:10.3760/cma.j.issn.1000-6672.2019.z1.026.
[42]	Enninger A, Schmidt P, Hasan C, et al. Multidrug-Resistant Organisms in Palliative Care: A Systematic Review. J Palliat Med, 2021, 24(1): 122-132. doi:10.1089/jpm.2019.0654. pmid: 33085565
[43]	Boyce JM. and and environmental hygiene: respective roles for MRSA, multi-resistant gram negatives, Clostridioides difficile, and Candida spp. Antimicrob Resist Infect Control, 2024, 13(1): 110. doi:10.1186/s13756-024-01461-x.
[44]	王雪玉, 田芳英. 基于DRGs的多重耐药菌感染防控现状分析. 暨南大学学报(自然科学与医学版), 2023, 44(1): 95-105. doi:10.11778/j.jdxb.20220264.
[45]	姚雨菲, 孙海超, 胡艺. ICU病人多重耐药菌感染危险因素的Meta分析. 循证护理, 2024, 10(15):2673-2680. doi:10.12102/j.issn.2095-8668.2024.15.003.
[46]	Serra-Burriel M, Keys M, Campillo-Artero C, et al. Impact of multi-drug resistant bacteria on economic and clinical outcomes of healthcare-associated infections in adults: systematic review and meta-analysis. PLoS One, 2020, 15(1): e0227139. doi:10.1371/journal.pone.0227139.
[47]	Ranjbar R, Alam M. Antimicrobial Resistance Collaborators (2022). Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Evid Based Nurs, 2023: ebnurs-2022-103540. doi:10.1136/ebnurs-2022-103540.