2006-2011年泌尿外科住院患者医院感染及多药耐药菌感染趋势分析

发布时间：2018-01-08 19:04

本文关键词：2006-2011年泌尿外科住院患者医院感染及多药耐药菌感染趋势分析　出处：《中华医院感染学杂志》2013年20期 　论文类型：期刊论文

【摘要】：目的了解2006-2011年泌尿外科住院患者医院感染及多药耐药菌(MDROs)感染率、分布特点及变化趋势,以改进医院感染预防控制措施。方法对2006-2011年入住泌尿外科21 508例患者及金黄色葡萄球菌、肠球菌属、大肠埃希菌、肺炎克雷伯菌和鲍氏不动杆菌培养阳性的患者进行前瞻性调查,调查医院感染及多药耐药菌感染情况。结果 6年内泌尿外科21 508例住院患者中发生医院感染125例,感染率为0.58%;感染部位主要为泌尿道、手术部位和菌(败)血症,分别占39.71%、23.53%、20.59%;共检出病原菌115株,以大肠埃希菌最多占50.43%;检出的金黄色葡萄球菌、肠球菌属、大肠埃希菌、肺炎克雷伯菌和鲍氏不动杆菌84株主要病原菌中检出多药耐药菌55株,检出率为65.48%,以产ESBLs大肠埃希菌检出率最高,占83.64%;通过采取控制措施,2009年产ESBLs大肠埃希菌医院感染率较2006年明显下降(RR=0.28,95%CI:0.05～1.06,P=0.04),控制效果较好。结论泌尿外科住院患者医院感染预防控制的重点为泌尿道感染,在病原菌中需关注大肠埃希菌,尤其是产ESBLs大肠埃希菌。
[Abstract]:Objective to investigate the 2006-2011 inpatients in the Department of Urology of hospital infection and multidrug resistant bacteria (MDROs) infection rate, distribution characteristics and change trend, to improve hospital infection prevention and control measures. Methods for 2006-2011 years in the Department of Urology in 21508 patients and Staphylococcus aureus, Enterococcus, Escherichia coli, Klebsiella pneumoniae and abalone Acinetobacter culture positive patients were investigated prospectively, the situation of hospital infection and multidrug resistant bacteria infection. Results 6 years department of Urology 21508 cases of hospitalized cases of nosocomial infections in the 125 patients, the infection rate was 0.58%; the main infection sites were urinary tract, surgical site and bacteria (defeat) blood, accounted for 39.71%, 23.53%, 20.59%; a total of 115 strains of pathogens, Escherichia coli accounted for 50.43%; the detection of Staphylococcus aureus, Enterococcus, Escherichia coli, Klebsiella pneumoniae and 84 strains of Acinetobacter baumannii The main pathogenic bacteria were detected in 55 strains of multi drug resistant bacteria, the detection rate was 65.48%, with ESBLs producing Escherichia coli was the highest, accounting for 83.64%; the control measures, annual output of 2009 ESBLs of Escherichia coli infection rate was significantly lower than in 2006 (RR=0.28,95%CI:0.05 - 1.06, P=0.04), the control effect is good. Focus on infection prevention and control conclusion Hospital Department of Urology for urinary tract infection, pathogens should be paid attention to on the Escherichia coli, especially Escherichia coli producing ESBLs.

【作者单位】：北京大学第一医院感染管理-疾病预防控制处;北京清华长庚医院医政处;
【基金】：中国医院协会医院感染预防与控制能力建设基金项目(20121210)
【分类号】：R446.5
【正文快照】： 泌尿外科患者手术类型复杂,而且腔镜操作较多,发生感染的风险较高;另外结合泌尿外科抗菌药物的使用特点,多药耐药菌(MDROs)发生的种类和耐药特点与其他科室患者也有所不同,为了解泌尿外科患者的医院感染及MDROs感染特点,更好地指导临床进行医院感染预防与控制,笔者对2006-2011

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