677例多药耐药菌医院感染病例分析

发布时间：2018-03-27 05:01

  本文选题：多药耐药菌　切入点：医院感染　出处：《中华医院感染学杂志》2017年18期

【摘要】：目的了解住院患者五大类多药耐药菌医院感染的现状、特点、分布规律及预后,为科学制定预防控制措施提供依据。方法通过医院感染实时监控系统,对某院2014年1月-2015年12月住院期间发生的耐碳青霉烯类鲍氏不动杆菌(CRAB)、耐碳青霉烯类铜绿假单胞菌(CRPA)、耐碳青霉烯类肠杆菌科细菌(CRE)、耐甲氧西林金黄色葡萄球菌(MRSA)、耐万古霉素肠球菌(VRE)等五大类多药耐药菌(MDRO)感染的患者进行目标性监测,医院感染专职人员对每份感染病历进行逐项查阅,并及时填写《多药耐药菌个案登记表》。结果监测期间,全院多药耐药菌检出率为61.18%,其中五大类多药耐药菌检出率为23.55%,导致发生医院感染677人次,770例次,五大类多药耐药菌医院感染日感染人次率0.29‰,日例次感染率0.34‰,五大类多药耐药菌医院感染人次感染率0.30%,例次感染率0.34%;感染患者平均(47.47±21.43)岁,平均住院天数(36.54±28.55)d;770株多药耐药菌构成中,CRAB 423株,占54.94%,CRPA 94株,占12.21%,CRE 180株,占23.38%,MRSA 71株,占9.22%,VRE 2株,占0.26%;标本来源以痰为主,其次是血标本和分泌物;感染部位中以下呼吸道居多,占45.08%,其次是手术部位感染和血流感染。五大类多药耐药菌医院感染日例次感染率排名前五位的科室分别为神经外科ICU(7.43‰)、中心ICU(7.11‰)、呼吸ICU(3.97‰)、神经内科ICU(3.91‰)、烧伤外科(1.52‰)。结论某院多药耐药菌检出形势严峻,五大类多药耐药菌医院感染导致患者住院时间延长、预后欠佳,因此应及时准确做好病原菌监测,提高标本送检质量,多学科协作强化多药耐药菌感染预防控制工作,进而保障患者安全。
[Abstract]:Objective to investigate the status, characteristics, distribution and prognosis of five major types of multidrug resistant bacteria (MDR) nosocomial infection in hospitalized patients, and to provide scientific basis for the establishment of preventive and control measures. Methods the real-time monitoring system for nosocomial infection was used. In a hospital from January 2014 to December 2015, Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus and Staphylococcus aureus, which were hospitalized from January 2014 to December 2015, were tested. Patients infected with vancomycin resistant Enterococcus enterococci (VREE) and other five major multidrug resistant bacteria (MDROs) were monitored on a targeted basis. The nosocomial infection staff consulted each case history item by item, and filled out the multidrug resistance case registration form in time. The detection rate of multidrug resistant bacteria in the whole hospital was 61.18, among which the detection rate of five major multidrug resistant bacteria was 23.55, which resulted in 677 hospital infections, and the nosocomial infection rate of five major multidrug resistant bacteria was 0.29 鈥，

本文编号：1670071