目的 Carbapenem抗生素為治療多重抗藥性菌的最後 防線，病人若感染CRE會有極高的死亡率。本單位 2013~2015年CRE感染密度由0‰上升至0.74‰，恐 造成病人嚴重併發症。本專案目的為降低加護病房 CRE感染密度。經現況分析原因為：未每日評估拔 除侵入性管路、新病人帶菌率高、未採集中隔離照 護、擦澡用物未維持清潔乾燥、未正確清潔消毒病 人區設備及環境。 方法 執行管路提示機制、實施接觸隔離防護查 核、實施集中隔離照護、實施2％Chlorhexidine Gluconate（CHG）拋棄式擦澡巾擦澡及擦拭管路、 實施醫護人員與清潔人員教育訓練。 結果 計畫執行後CRE感染密度下降至0‰，達專案目 標值0.48‰以下；整體而言本單位的總感染密度由 8.4‰下降至4.3‰，整體影響層面顯著。 結論 本專案強調管路盡早移除以及確實執行隔離措 施，嘗試以2％CHG拋棄式擦澡巾擦澡取代傳統式擦 澡，逐一克服單價高以及保溫問題後，其實新的擦 澡方式更簡易，且可明顯降低感染問題，為了讓大 家看到2％CHG擦澡及擦拭管路的益處，期能藉此專 案成效提供其它加護病房之參考。（澄清醫護管理 雜誌 2019；15（2）：75-82）

Purposes The antibiotic carbapenem is the last line of defense against multi-drug resistant organisms (MDROs), and patients infected with carbapenem-resistant Enterobacteriaceae (CRE) have an extremely high mortality rate. From 2013 to 2015, the incidence of CRE infection increased from 0‰ to 0.74‰ in our institution, raising concerns that this would cause serious complications in patients. The purpose of this project was to reduce the incidence of CRE infection in intensive care units (ICUs). According to our analysis of the current situation, the causes for CRE infection were: 1. We did not assess the possibility of removing invasive catheters every day. 2. We did not properly implement contact isolation protection measures. 3. Centralized isolated care was not adopted. 4. The towels for sponge bath were not kept clean and dry. 5. The equipment and environment were not properly cleaned and disinfected. Methods We designed several strategies to reduce the incidence of CRE infection: 1. Implement a catheter removal prompting system. 2. Carry out examinations on contact isolation protection. 3. Adopt centralized isolated care. 4. Use disposable towels with 2% chlorhexidine gluconate (2% CHG) for sponge baths and catheter cleaning. 5. Arrange training for medical staff and sanitation workers. Results After implementation of the program, the incidence of CRE infection decreased to 0‰, while the target value was 0.48‰. Overall, the total incidence of infection dropped from 8.4‰ to 4.3‰, with significant level of influence. Conclusions Our project highlights the importance of removing catheters as soon as possible and effectively implementing the isolation protection measures. Instead of the traditional sponge bath towels, we used disposable sponge bath towels with 2% CHG. If we can overcome the problems of high cost and thermal insulation, the new sponge bath technique is much easier and can significantly reduce infection. This study aims to show the benefits of sponge bath and catheter cleaning with 2% CHG in the hope of providing a reference for other ICUs with the success of this project. (Cheng Ching Medical Journal 2019; 15(2): 75-82)