三甲医院近三年CRE感染特征分布及发生率变迁所带来的思考

发布时间：2018-11-16 13:33

【摘要】：目的通过对医院近三年临床标本检出耐碳青霉烯类肠杆菌科细菌(CRE)患者进行实时监控分析,对临床经验性治疗及感染控制给予帮助。方法 2013年1月1日-2015年12月31日通过院感实时监控系统进行前瞻性全面综合性监测,判定医院感染、院外感染或定植,研究标本及菌种来源、发现率变化、感染部位分布特征等。结果 2013-2015年共检出CRE分离菌株111株,其中35株为医院感染菌株、59株为院外感染菌株、17株为定植菌,呼吸道标本占50.45%、血液标本占6.31%、其他无菌体液标本占13.51%;主要菌种来源:肺炎克雷伯菌占59.46%,大肠埃希菌占25.23%;2013-2015年院内CRE发现率波动在0.108‰~0.224‰,院内、院外及定植CRE发现率波动在0.346‰~0.734‰;院内及院外CRE感染部位分布主要为下呼吸道感染,占46.81%,发生7例呼吸机相关性肺炎医院感染,腹(盆)腔组织及腹水感染占12.77%,其中9例为院外感染。结论 2013-2015年CRE发现率呈上升趋势,感染以下呼吸道为主,防止CRE的产生需对患者高危因素进行评估,进一步降低感染风险,同时合理使用抗菌药物。
[Abstract]:Objective to analyze the real-time monitoring and analysis of (CRE) patients with carbapenem resistant Enterobacteriaceae in clinical specimens in recent three years, and to provide help for clinical experience therapy and infection control. Methods from January 1, 2013 to December 31, 2015, a comprehensive and prospective monitoring system was used to determine nosocomial infection, nosocomial infection or colonization, study specimen and source of bacteria, and change of detection rate. Distribution of infection sites. Results A total of 111 strains of CRE were isolated in 2013-2015, of which 35 were nosocomial, 59 were nosocomial, 17 were colonized, 50.45in respiratory tract and 6.31 in blood. Other aseptic body fluid samples accounted for 13.51%. The main sources of bacteria were Klebsiella pneumoniae 59.46%, Escherichia coli 25.23%, and the detection rate of CRE ranged from 0.108 鈥，

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