多药耐药菌医院感染流行病学特征与干预效果评价

发布时间：2018-03-01 15:09

本文关键词： 多药耐药菌医院感染干预措施　出处：《中华医院感染学杂志》2017年12期 　论文类型：期刊论文

【摘要】：目的了解多药耐药菌(MDRO)医院感染情况,评价干预效果,为后期持续改进提供理论依据。方法回顾性调查医院2014年1月-2016年9月住院患者MDRO医院感染监测结果,分析MDRO医院感染流行病学特征,采取综合干预措施,2014年1月-2015年5月数据为干预前组,共调查患者102 692例;2015年6月-2016年9月为干预后组,共调查患者97 577例,比较两组患者MDRO感染率,评价干预效果。结果 2014年1月-2016年9月年共监测住院患者200 269例,共检出MDRO 1 552株,其中院内感染MDRO 449株,MDRO感染率为0.22%;不同性别、年龄患者感染率差异有统计学意义(P0.05);院内感染MDRO致病菌前5位分别为鲍氏不动杆菌(45.66%)、金黄色葡萄球菌(17.82%)、铜绿假单胞菌(17.37%)、肺炎克雷伯菌(14.25%)和大肠埃希菌(2.45%);科室分布以ICU为主(46.32%),其次为外科、内科、新生儿与妇产科;季节分布呈现一、三季度高于二、四季度现象;通过采取综合性干预措施,MDRO感染株数由267株下降至182株,感染发生率由基线期0.26%下降至干预期0.19%,差异有统计学意义(P0.05)。结论采取有针对性综合性干预措施,可有效降低多药耐药菌医院感染的风险,对保障医疗质量与安全具有重要意义。
[Abstract]:Objective to investigate the nosocomial infection of multidrug resistant bacteria (MDR), evaluate the effect of intervention, and provide theoretical basis for continuous improvement in the later period. Methods the results of MDRO nosocomial infection surveillance in hospitalized patients from January 2014 to September 2016 were retrospectively investigated. The epidemiological characteristics of nosocomial infection in MDRO were analyzed and comprehensive intervention measures were taken. A total of 102,692 patients were investigated in the pre-intervention group from January 2014 to May 2015, and 97 577 patients in the post-intervention group from June 2015 to June 2015. Results from January 2014 to September 2016, a total of 200,269 MDRO strains were detected and 1 552 strains of MDRO were detected. The infection rate of MDRO 449 strains in hospital was 0.22%. The infection rate of age patients was significantly different (P 0.05), the top five pathogens of nosocomial infection of MDRO were Acinetobacter baumannii 45.66, Staphylococcus aureus 17.82, Pseudomonas aeruginosa 17.3737 and Klebsiella pneumoniae 14.255.The first five pathogens were Acinetobacter baumannii and Acinetobacter baumannii. ICU was the main part, and the second was surgery. Internal medicine, newborn and obstetrics and gynecology; seasonal distribution was higher in the first and third quarters than in the second and fourth quarters; the number of MDRO infection strains decreased from 267 to 182 through comprehensive intervention. The incidence of infection decreased from 0.26% in the baseline period to 0.19 in the dry period, the difference being statistically significant (P 0.05). Conclusion the risk of nosocomial infection caused by multidrug resistant bacteria can be effectively reduced by taking targeted comprehensive intervention measures, and it is of great significance to ensure the quality and safety of medical treatment.
【作者单位】：连云港市第一人民医院感染管理科;连云港市第一人民医院质量与安全管理办公室;连云港市第一人民医院微生物室;
【基金】：连云港市第一人民医院青年英才豪森基金资助项目(QN160205)
【分类号】：R181.3;R51

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