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| 446例住院患者医院内多重耐药菌感染监测结果及分析 |
| The monitoring results and analysis about 446 cases of hospitalized patients with multi-resistant bacteria infection |
| 投稿时间：2015-01-10 修订日期：2015-03-14 |
| DOI：10.3969/j.issn.1000-0399.2015.07.006 |
| 中文关键词: 院内感染 监测 多重耐药菌 耐药分析 |
| 英文关键词: Hospital, infection Monitoring Multi-drug resistant bacteria Drug resistance analysis |
| 基金项目: |
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| 中文摘要: |
| 目的 了解2013年度某三甲医院医院感染中多重耐药菌感染状况。方法 对住院的53 885例患者进行医院内多重耐药菌感染监测,分析多重耐药菌医院内感染患者的科室分布、感染部位以及药敏状况,并对相关因素进行分析。结果 53 885例住院患者中发生医院感染1 589例,其中多重耐药菌感染446例,标本主要来源于痰液、尿液、血液、粪便及其他分泌物,医院内多重耐药菌感染发生率较高的科室为血液内科、特诊一科、EICU、儿科血液病区;感染部位主要以下呼吸道和上呼吸道高居首位,其次为泌尿道和胃肠道;多重耐药菌感染以产超广谱B内酰胺酶细菌最多(70.5%,其中ESBL大肠埃希氏菌52.7%,ESBL肺炎克雷伯菌17.8%),其次分别为耐甲氧西林葡萄球菌(10.2%)、多重耐药鲍曼不动杆菌为(7.0%)、多重耐药铜绿假单胞菌(2.2%)。结论 该三甲医院2013年度医院内感染多重耐药菌较多的科室主要为血液内科、特诊一科、EICU、儿童血液病区,年龄、住院时间、侵入性操作、并发症、激素的应用是医院多重耐药菌感染的危险因素,产超广谱B内酰胺酶细菌是主要多重耐药菌。 |
| 英文摘要: |
| Objective To investigate the status of monitoring on the multiple drug-resistant bacteria infection in the hospital, the distribution of department and the multiple drug-resistant bacteria in this hospital in 2013. Methods A total of 53 885 cases of hospitalized patients were monitored and the nonsocial MDR infection's department distribution, infection site and drug sensitivity were analysed. Results Among these 53 885 cases of hospitalized patients, there were 1 589 cases with infection and 446 cases with MDR infection. Most of the samples were from sputum, urine, blood, feces and other secretions. The Department of Hematology, Special Clinic Department, EICU and Pediatrics Blood Ward had higher incidence of medical infection with MDR. The main infection sites were lower respiratory tract and upper respiratory tract ranked, followed by the urinary tract (9.1%) and gastrointestinal tract (8.5%). The extended-spectrum bacteria (70.5%); ESBL 52.7% ESBL, Escherichia coil, Kielbasi pneumatic(17.8%) had the highest infection rate, followed by the resistance of staph infection (10.2%), the multiple drug-resistant BA(7%) and the multiple drug-resistant PA (2.2%). Conclusion During the year 2013, in our third-grade class-A hospital, the rate of infection in hospital with MDR is much higher mainly in these departments: the Department of Specific Diagnosis, the Department of Hematology, EICU, and Pediatric Hematology Ward. The risk factors of hospital infection with MDR are age, hospitalization time, anti-tumor treatment, critical underlying diseases and the application of hormone, and the main drug-resistant bacteria is the one producing extended-spectrumβbacteria. |
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