急诊重症监护病房多药耐药菌监测与感染危险因素分析

发布时间：2018-05-05 21:35

  本文选题：急诊重症监护室 + 多药耐药菌监测　； 参考：《中华医院感染学杂志》2017年20期

【摘要】：目的分析急诊重症监护病房(EICU)多药耐药菌的分布及感染危险因素。方法回顾性调查2016年1月-12月医院88例EICU住院患者的临床资料,比较多药耐药组42例患者和非多药耐药组46例患者的差异,分析多药耐药菌的分布特征,对多药耐药菌感染相关因素进行分析。结果共检出多药耐药致病菌42株,多药耐药菌依次为耐碳青霉烯类抗菌药物鲍氏不动杆菌(CR-AB)32株占76.19%、耐甲氧西林金黄色葡萄球菌(MRSA)5株占11.90%、耐碳青霉烯类抗菌药物肠杆菌科细菌(CRE)3株占7.14%;CR-AB对头孢哌酮/舒巴坦、替加环素的耐药率分别为18.75%、0.00%,MRSA对替加环素的耐药率为0.00%,MDR-PA对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、替加环素耐药率为0.00%;住院时间14d、抗菌药物使用时间3d、中心静脉置管、气管插管、留置导尿管或胃管、机械通气时间≥2d均为EICU患者多药耐药菌感染相关的独立危险因素(P0.05)。结论 EICU患者多药耐药菌感染是多因素共同引起的结果,临床应针对性采取综合有效措施,降低EICU患者多药耐药菌感染,阻断多药耐药菌的传播。
[Abstract]:Objective to analyze the distribution of multidrug resistant bacteria in emergency intensive care unit (EICU) and the risk factors of infection. Methods the clinical data of 88 patients with EICU in hospital from January to December 2016 were retrospectively investigated. The differences between 42 patients in multidrug resistance group and 46 patients in non-multidrug resistance group were compared, and the distribution characteristics of multidrug resistance bacteria were analyzed. The related factors of multidrug resistant bacteria infection were analyzed. Results A total of 42 strains of multidrug resistant pathogens were detected. The multidrug resistant strains were carbapenem resistant Acinetobacter baumannii 32 strains (76.19%), methicillin-resistant Staphylococcus aureus 5 strains (11.90%) and carbapenem resistant Enterobacteriaceae strains (7.14 CR-AB) to cefoperazone / sulbactam (7.14 CR-AB). The resistance rates of tegicycline to tegacycline were 18.75 and 0.0075 respectively. The resistance rate of MRSA to tegacyclin was 0.005. The MDR-PA resistance rate was 0.005% to cefoperazone / sulbactam, piperacillin / tazobactam, imipenem, piperacillin / tazobactam, and imipenem, respectively. The rate of tegacycline resistance was 0.00g, the hospitalization time was 14 days, the use time of antimicrobial agents was 3 days, the central venous catheter, tracheal intubation, indwelling catheter or gastric tube, the mechanical ventilation time 鈮，

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