重症医学科住院患者多药耐药菌感染的临床分析及耐药性监测

发布时间：2018-03-29 09:49

本文选题：多药耐药菌　切入点：临床分析　出处：《中华医院感染学杂志》2017年11期

【摘要】：目的对重症医学科(ICU)住院患者多药耐药菌感染状况进行调查分析,了解医院ICU感染谱以及多药耐药菌(MDRO)的流行趋势,为预防和控制多药耐药菌在医院内传播,降低医院感染率提供依据。方法本研究采取回顾性研究方法,统计分析2015年12月-2016年11月,在医院ICU住院患者632例,1 296份送检标本的培养结果进行临床分析。结果调查合格标本1 296份,共分离出病原菌503株,分离率为38.81%;其中分离出MDRO 181株,占35.98%;检出的MDRO类型主要包括耐碳青霉烯类鲍氏不动杆菌(CRABA,20.44%)、产ESBLs大肠埃希菌(19.89%)、产ESBLs肺炎克雷伯菌(16.57%)、耐甲氧西林金黄色葡萄球菌(MASA,6.63%)、耐碳青霉烯类铜绿假单胞菌(CRPAE,4.97%)等;MDRO检出主要来源于痰液、血液、尿液、脓液、渗出液、胆汁等标本,分布于呼吸道(56.35%),菌血症(12.71%);泌尿道(7.18%),器官腔隙(6.63%),手术部位切口(5.52%);绝大部分MDRO能耐受多种常用抗菌药物。结论 MDRO已成为医院感染的主要病原菌,合理应用抗菌药物、严格落实感控措施对预防和控制MDRO的产生和传播起到重要作用。
[Abstract]:Objective to investigate and analyze the infection status of multidrug resistant bacteria (MDR) in inpatients of intensive care department (ICU), and to understand the prevalence trend of nosocomial ICU infection and multidrug resistant bacteria (MDR) in order to prevent and control the spread of MDR in hospitals. Methods A retrospective study was conducted to analyze the data from December 2015 to November 2016. The results of culture of 1 296 samples from 632 patients with ICU in hospital were analyzed. Results A total of 503 strains of pathogenic bacteria were isolated from 1 296 eligible samples, and the isolation rate was 38. 81%, among which 181 strains of MDRO were isolated. The main types of MDRO detected included carbapenem resistant Acinetobacter baumannii 20.44, ESBLs Escherichia coli 19.89, Klebsiella pneumoniae 16.5775, methicillin-resistant Staphylococcus aureus 6.63, carbapenem resistant Pseudomonas aeruginosa 4.97). The results were mainly from sputum. Blood, urine, pus, exudate, bile, etc. Distributed in the respiratory tract 56.35m, bacteremia 12.71; urinary tract 7.18, organ lacunae 6.63m, surgical site incision 5.52; most of MDRO can withstand many kinds of commonly used antibiotics. Conclusion MDRO has become the main pathogen of nosocomial infection, and the rational use of antimicrobial agents. Strict implementation of sensitive control measures to prevent and control the production and transmission of MDRO plays an important role.
【作者单位】：青岛大学附属医院物资供应部;青岛大学附属医院感染管理部;青岛大学附属医院眼科;
【分类号】：R446.5

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