ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (11): 1293-1299.doi: 10.3761/j.issn.2096-7446.2026.11.002

• 论著 • 上一篇    下一篇

ICU耳念珠菌感染防控策略的构建与应用效果研究

肖艳艳1(), 王芳1, 袁翠1,*(), 张冰丽2, 姚希2, 李双玲1, 陈凯笙1   

  1. 1 北京大学第一医院重症医学科 北京市 100034
    2 北京大学第一医院感染管理-疾病预防控制处 北京市 100034
  • 收稿日期:2025-12-10 出版日期:2026-11-10 发布日期:2026-11-06
  • 通讯作者: *袁翠，E-mail：yuancui2013@sina.com
  • 作者简介:肖艳艳：女，硕士，主管护师，E-mail：xiaoyanyan718@126.com
    作者贡献声明

    肖艳艳：研究设计、论文撰写；王芳：统筹协调、研究实施；袁翠：研究设计、论文修改；张冰丽、姚希、李双玲、陈凯笙：研究指导

  • 基金资助:
    国家自然科学基金项目(72404004)

Construction and application of prevention and control strategies for Candida auris infection in intensive care unit

XIAO Yanyan1(), WANG Fang1, YUAN Cui1,*(), ZHANG Bingli2, YAO Xi2, LI Shuangling1, CHEN Kaisheng1   

  1. 1 Department of Critical Care Medicine， Peking University First Hospital， Beijing 100034， China
    2 Department of Infection Management-Disease Prevention and Control， Peking University First Hospital， Beijing 100034， China.
  • Received:2025-12-10 Online:2026-11-10 Published:2026-11-06
  • Contact: *YUAN Cui，E-mail：yuancui2013@sina.com
  • Supported by:
    National Natural Science Foundation of China(72404004)

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摘要：

目的 构建基于多学科协作的ICU耳念珠菌感染防控策略，并评价其在临床情境的应用效果。 方法 系统检索国内外耳念珠菌防控管理相关文献，结合医院感染管理、重症医疗及护理等多学科专家意见，制订涵盖多方面措施的规范化耳念珠菌感染防控策略。以2024年8月—2025年10月入住北京市某三级甲等医院ICU检出耳念珠菌的患者为研究对象，通过环境及人员取样监测，结合泊松回归模型，分析比较策略实施前后多重耐药菌感染率的变化趋势，评价防控策略的应用效果。 结果 共纳入16例患者，首次检出耳念珠菌标本以皮肤拭子为主，为6例，占37.5%；感染类型中医院定植为12例，占75.0%；期间未发生医院感染暴发事件；共采集116例环境及人员标本，结果均未检出耳念珠菌。相较于基线期，泊松回归分析显示，多重耐药菌千床日感染率整体呈现显著下降（0.81‰，IRR=0.211，95%CI：0.060~ 0.747，P=0.016）后回升的趋势（2.55‰，IRR=0.668，95%CI：0.289~1.546，P=0.346），IRR为发病率比（incidence rate ratio）。 结论 该研究融合国内外推荐建议构建了多学科协作—循证优化—闭环督导的耳念珠菌标准化感染防控策略，并提出每日按需强化清洁消毒联合复合式终末消毒方案，可以有效遏制耳念珠菌交叉传播，防止医院感染暴发，并验证该策略对ICU其他多重耐药菌的协同防控效果，为医疗机构感染防控管理提供参考依据。

关键词: 重症监护病房, 耳念珠菌, 医院感染, 防控策略

Abstract:

Objective To develop a multidisciplinary collaboration-based infection prevention and control strategy for Candida auris in intensive care units（ICUs），and to evaluate its effectiveness in clinical practice. Methods A systematic literature review was conducted on Candida auris prevention and control measures，combining the opinions of multidisciplinary experts in hospital infection management，critical care，and nursing to develop a standardized management process for Candida auris prevention and control that covered multiple measures. Patients identified with Candida auris colonization or infection upon admission to the ICU of a tertiary hospital in Beijing between August 2024 and October 2025 were included. Environmental and personnel sampling was performed. The impact of the strategy was assessed by comparing trends in multi-drug resistant organisms infection rates before and after implementation using a Poisson regression model. Results A total of 16 patients were included. Initial positive specimens for Candida auris was mainly based on skin swabs（n=6，37.5%）. 12 cases（75.0%） were hospital-acquired colonization. None of the 116 environmental and personnel specimens collected detected Candida auris. Poisson regression analysis showed an initial sharp decline（0.81‰，IRR=0.211，95%CI：0.060~0.747，P=0.016） followed increase（2.55‰，IRR=0.668，95%CI：0.289~1.546，P=0.346）in multi-drug resistant organisms infection rate compared to baseline. Conclusion In this study，a standardized control strategy for Candida auris was established based on multidisciplinary collaboration，evidence-based optimization and closed supervision while integrating domestic and international recommendations. And it had proposed daily demand-based enhanced cleaning and disinfection combined with comprehensive terminal disinfection. The results showed that this approach could effectively prevent cross-transmission of Candida auris and prevent hospital infection outbreaks. It also verified the collaborative control effect of this strategy on other multidrug resistant organisms in the ICU for the first time，providing a reference for the management of Candida auris infection prevention in ICUs.

Key words: Intensive Care Unit, Candida Auris, Hospital Infection, Control Strategies