对于超级细菌/多重耐药菌，要防被忽悠(hūyou)，更要防止麻木！耐药菌的难题(nántí)，远不止NDM-1！什么(shénme)是多重耐药菌？2025/3/7医院感染(gǎnrǎn)越来越险恶！2005-2009年上海XX医院鲍曼不动杆菌(gǎnjūn)对亚胺培南耐药率变化正确认识接触预防有效(yǒuxiào)控制多重耐药菌MDRO耐药菌增加(zēngjiā)的原因AntimicrobialResistance恶性循环(èxìngxúnhuán)2025/3/72010年上海某医院ICU中22例病人痰培养(péiyǎng)检出多重耐药菌－鲍曼不动杆菌，PFGE结果NationalPatientSafetyGoals,Hospital&CriticalAccessHospital,2009美国(měiɡuó)NationalPatientSafetyGoalSpreadofMDROsCanBeControlledBy:FIGHTS卫生部办公厅关于印发《多重耐药菌医院感染(gǎnrǎn)预防与控制技术指南（试行）》的通知（）/WHO抵御细菌(xìjūn)耐药的6项政策最新MDROBundle超级细菌出现/MDRO泛滥(fànlàn)，我们需要改变什么呢？2025/3/7酒精(jiǔjīng)擦手的优点2025/3/7接触(jiēchù)隔离的要求2025/3/7多重耐药菌进行(jìnxíng)专门标记（德国某医院）何时(héshí)开始隔离？何时(héshí)解除隔离？2025/3/7ICU减少共用(ɡònɡyònɡ)物品2025/3/72025/3/7PathogenSurvivalintheEnvironment手频繁(pínfán)接触的物体表面，是高度危险的！/High-touchequalshigh-risk:surfacecleaningplushandhygienekeytoHAIpreventionICU中，容易(róngyì)被污染的物表ICU环境(huánjìng)中耐药鲍曼不动杆菌污染严重ManualCleaning病区的基本(jīběn)配置：清洗消毒机日本尿壶(niàohú)与便盆的消毒关注(guānzhù)频繁手接触物体表面的去污染MICROFIBERThe“cleaner”cleaningsystem关东病院设备科-保养(bǎoyǎng)与维修HowCanWeEvaluateEnvironmentalCleaningTESTINGOFSURFACESATPbioluminescenceATPispresentinblood,skincells,otherbodilyfluidsandmicrobes.ATP存在(cúnzài)于血液，皮肤细胞，其它体液和微生物中。DazoSolution(Initiallycalled“GOO”)/PROPORTIONOFOBJECTSCLEANEDASPARTOFTERMINALROOMCLEANINGIN20ACUTECAREHOSPITALS17HOSPITALSHospitalsEnvironmentalHygieneStudyGroup36HospitalResultsTERMINALROOMCLEANINGINFECTIONPREVENTIONTARGETSSinkandFaucetsToiletSurfacesToiletFlushHandleBedpanCleanerToiletAreaHandholdsToiletAreaDoorKnobsorPushPlatesBedsideTableTrayTablePatientChairSideRailsRoomDoorKnobsCallBoxTelephoneBathroomLightSwitchesEvaluatingPatientZoneEnvironmentalHygiene如何选择(xuǎnzé)表面消毒剂LowandIntermediateLevelDisinfectantsExamplesofLow&IntermediateLevelDisinfectantsClean/disinfect:Onaregularbasis,Whenspillsoccur,WhenvisiblysoiledFollowmanufacturers’instructionsforproperuse:use-dilution,dwelltime,materialcompatibility,storage,shelf-life.1:10BleachrecommendedforC.difficile2025/3/7ReservoirforSpreadofAntib