重症监护病房医务人员鼻前庭细菌定植情况及耐药性调查

发布时间：2018-06-05 20:02

本文选题：重症监护病房 + 医务人员　；参考：《中国感染控制杂志》2016年08期

【摘要】：目的了解重症监护病房(ICU)医务人员鼻前庭病原菌定植情况,为加强ICU医院感染的预防与控制提供依据。方法 2015年5月主动筛查某院ICU非感染状态下的医务人员鼻前庭细菌定植情况,并进行细菌培养、菌株分离及菌种鉴定。分析调查结果并与同期患者检出细菌的耐药情况进行比较。结果共调查医务人员96名,从鼻前庭标本中分离病原菌43株,分别来自不同的医务人员,病原菌分离率及携带率均为44.79%。分离的主要病原菌为金黄色葡萄球菌(15株,占34.88%),其次为产气肠杆菌(9株,占20.93%)、肺炎克雷伯菌(7株,占16.28%)等。医生、经常吸烟及从不锻炼的医务人员鼻前庭病原菌的检出率较高,差异具有统计学意义(均P0.05)。43株病原菌中检出1株耐亚胺培南的肺炎克雷伯菌。医务人员检出的7株肺炎克雷伯菌对氨苄西林/舒巴坦、头孢唑林、呋喃妥因的耐药率均50.00%,对头孢噻肟与亚胺培南的耐药率分别为28.57%、14.29%;同期患者检出的11株肺炎克雷伯菌对呋喃妥因的耐药率为100.00%,对其他常用抗菌药物均敏感。医务人员检出的4株大肠埃希菌对氨苄西林的耐药率为75.00%,对庆大霉素、妥布霉素、左氧氟沙星、环丙沙星及复方磺胺甲口恶唑的耐药率均为50.00%,而同期患者检出的6株大肠埃希菌对大部分常用抗菌药物均耐药。结论长期工作在ICU的医务人员鼻前庭病原菌定植率高,定期主动对医务人员鼻前庭病原菌定植情况进行筛查及监测,对预防医院感染,防止医务人员与患者之间的交叉传播具有重要意义。
[Abstract]:Objective to investigate the pathogen colonization of nasal vestibule of ICU medical staff in intensive care unit (ICU), and to provide evidence for strengthening the prevention and control of nosocomial infection in ICU. Methods in May, 2015, the nasal vestibular bacterial colonization of medical staff in ICU of a hospital was actively screened, and bacteria culture, isolation and identification of bacteria were carried out. The results were analyzed and compared with the drug resistance of bacteria detected in the same period. Results A total of 96 medical workers were investigated and 43 strains of pathogenic bacteria were isolated from nasal vestibule specimens. The isolation rate and carrying rate of pathogenic bacteria were 44.79 and 44.79 respectively. The main pathogenic bacteria isolated were Staphylococcus aureus 15 strains (34.88m), Enterobacter aerogenes 9 strains (20.93%), Klebsiella pneumoniae 7 strains (16.28%) and so on. Doctor, the detection rate of nasal vestibular pathogens in medical workers who often smoked and never exercised was higher, and the difference was statistically significant (all P0.05%. 43 strains of pathogenic bacteria were detected one Klebsiella pneumoniae resistant to imipenem. Seven strains of Klebsiella pneumoniae were detected by medical workers for ampicillin / sulbactam, cefazolin, The resistance rates to cefotaxime and imipenem were 28. 57 and 14. 29, respectively, and the resistance rates of 11 Klebsiella pneumoniae to furantoin were 10. 00g, sensitive to other commonly used antimicrobial agents. The resistance rate of 4 strains of Escherichia coli to ampicillin was 75.00%, and to gentamicin, tobramycin, levofloxacin. The drug resistance rates of ciprofloxacin and compound sulfamethoxazole were 50.00,6 strains of Escherichia coli were resistant to most commonly used antibiotics. Conclusion the pathogen colonization rate of nasal vestibule is high among the medical staff who have been working in ICU for a long time. It is necessary to screen and monitor the pathogen colonization of nasal vestibule regularly and to prevent nosocomial infection. It is of great significance to prevent the cross-transmission between medical staff and patients.
【作者单位】：第三军医大学第三附属医院野战外科研究所;
【分类号】：R446.5;R459.7

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