30家医院重症监护室多药耐药菌感染分布特征

发布时间：2019-01-17 14:35

【摘要】：目的通过对全国30家医院重症监护室多药耐药菌感染数据的调查,更加全面的了解重症监护病房多药耐药菌感染的病原体分布特点。方法选取2014年11月-2016年6月30家医院感染管理专职人员主动监测,每月上报1~2个ICU住院患者多药耐药菌感染病原菌种类、标本来源、感染部位等情况,并观察医护人员手卫生执行情况,填写监测表格。结果共上报多药耐药菌感染3 152例次,多药耐药菌株3 313株,耐碳青霉烯鲍氏不动杆菌1 572株,占47.45%;多耐药肺炎克雷伯菌476株,占14.37%;多耐药铜绿假单胞菌441株,占13.31%;MRSA共321株,占9.69%;大肠埃希菌238株,占7.18%;耐万古霉素肠球菌110株,占3.32%;其他多药耐药菌155株,占4.68%;痰、尿和血标本为最常见的送检标本,院外感染中痰标本所占比例大,而尿标本和血标本在院内感染所占比例大;医院内感染中呼吸机相关肺炎和导尿管相关感染发生率较高,院外感染中下呼吸道感染为主。结论重症监护室最常见的多药耐药菌为耐碳青霉烯鲍氏不动杆菌、多耐药肺炎克雷伯菌、多耐药铜绿假单胞菌;在医院内感染中呼吸机相关肺炎和导尿管相关感染发生率较高,侵入性操作仍然是多药耐药菌感染的重点环节。
[Abstract]:Objective to investigate the data of multidrug resistant bacteria (MDR) infection in intensive care units (ICU) of 30 hospitals in China, and to understand the pathogen distribution characteristics of MDR infection in intensive care units (ICU). Methods from November 2014 to June 2016, 30 nosocomial infection management professionals were selected for active surveillance, and 1 ~ 2 ICU inpatients were reported with pathogenic bacteria, source of samples, infection site and so on. Observe the hand hygiene of medical staff and fill out the monitoring form. Results A total of 3 152 cases of multidrug resistant infections were reported, 3 313 strains of multidrug resistant strains, 1 572 strains of Acinetobacter baumannii resistant to penicillin, 47.45 000 strains of Acinetobacter baumannii, 476 strains of Klebsiella pneumoniae (14. 37%), and 1 572 strains of Acinetobacter baumannii were reported. There were 441 strains of Pseudomonas aeruginosa, accounting for 13.31 MRSA (9.69%), 238 strains of Escherichia coli (7.18%), 110 strains of vancomycin resistant Enterococcus (3.32%), 155 strains of other multidrug resistant bacteria (4.68%). Sputum, urine and blood samples were the most common specimens. The proportion of sputum specimens was large in the infection of hospital, but the proportion of urine and blood samples in the nosocomial infection was large. The incidence of ventilator-associated pneumonia and urethral catheter infection was higher in nosocomial infection, and lower respiratory tract infection was dominant in nosocomial infection. Conclusion the most common multidrug resistant bacteria in intensive care unit are Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The incidence of ventilator-associated pneumonia and urethral catheter infection in hospital infection is high. Invasive operation is still the key link of multidrug resistant bacteria infection.
【作者单位】：解放军总医院感染管理与疾病控制科;第三军医大学大坪医院感染控制科;广州军区广州总医院感控科;陆军总医院感染控制科;陆军总医院263临床部感染控制科;西藏军区总医院感控科;武汉总医院疾病预防控制科;济南军区总医院疾病预防控制科;兰州总医院感染控制科;南京总医院感染管理科;福州总医院感染控制科;沈阳军区总医院感染控制科;第二军医大学长海医院感染控制科;第二军医大学上海长征医院感染控制科;第二军医大学附属东方肝胆外科医院感染控制科;第三军医大学西南医院感染控制科;第三军医大学新桥医院感染控制科;第四军医大学西京医院疾病预防控制科;第四军医大学唐都医院疾病预防控制科;海军总医院感染控制科;解放军总医院第一附属医院感染控制科;解放军305医院感染感染控制科;解放军306医院感染控制科;解放军307医院感染控制科;解放军309医院感染控制科;解放军总医院海南分院感染管理与疾病控制科;武装警察总医院感染控制科;解放军第113医院感染控制科;解放军第153医院感染控制科;解放军第81医院感染控制科;
【基金】：中国医院协会中国医院感染监测信息化建设基金资助项目(CHA-2016-026-053)
【分类号】：R446.5

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