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| 某三甲医院8年耐碳青霉烯革兰阴性杆菌院内感染特征分析 |
| Epidemiological characteristics and analysis ofCarbapenem-resistant organism in agrade III level A hospitalin recent eight years |
| 投稿时间：2019-11-23 |
| DOI：10.3969/j.issn.1000-0399.2020.11.010 |
| 中文关键词: 耐碳青霉烯革兰阴性杆菌 院内感染 特征 |
| 英文关键词: Carbapenem-resistant organism Hospital acquired infections Characteristics |
| 基金项目:淮北市科技局资助课题(项目编号:rj201815) |
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| 中文摘要: |
| 目的 分析某三甲医院8年耐碳青霉烯革兰阴性杆菌(CRO)院内感染情况,为持续改进院内感染质量提供参考依据。方法 回顾性调查 2011~2018年淮北市人民医院347 347例住院患者中 CRO的检出率与院内感染发病率,分析CRO检出率与院内感染发病率时间变化趋势以及院内感染患者的常见发生部位、人群、科室分布等特征。结果 347 347例住院患者共分离出348株耐碳青霉烯鲍曼不动杆菌(CRAB)、81株耐碳青霉烯铜绿假单胞菌(CRPA)、66株耐碳青霉烯大肠埃希菌(CREC)和101株耐碳青霉烯肺炎克雷伯菌(CRKP),合计596株CRO,总检出率9.14%;8年间CRO检出率呈先升高后下降趋势(P<0.05);发生CRO院内感染223例(0.06%),连续8年CRO院内感染发病率呈先升后降趋势,差异有统计学意义(P<0.05);不同性别和年龄患者院内感染发病率差异有统计学意义(P<0.05)。院内感染病原菌以CRAB为主,占77.08%;主要分布在重症医学科(58.74%)和脑外科(27.80%);以呼吸道感染(85.59%)为主。结论 持续开展多重耐药菌防控能够有效降低CRO院内感染的发生与传播,应重点加强高风险人群、高风险科室和高发感染部位的管控。 |
| 英文摘要: |
| Objective To analyze the hospital-acquired infections of carbapenem-resistant organism (CRO) in a grade III level A hospitalin recent 8 years, so as to provide reference for clinical infection prevention and control. Methods The detection rate of CRO and the incidence of nosocomial infection among 34 7347 inpatients in our hospital from 2011 to 2018 were retrospectively investigated. The changing trend of CRO detection and nosocomial infection time was analyzed, so did thenosocomial infection site, population, and department distribution characteristics. Results A total of 348 strains of carbapenem-resistant Acinetobacter baumannii (CRAB), 81 strains of carbapenem-resistant Pseudomonas aeruloides (CRPA), 66 strains of carbapenem-resistant Escherichia coli (CREC) and 101 strains of carbapenem-resistant Klebsiella pneumoniae (CRKP) were isolated, with a total of 596 strains of CRO and a total detection rate of 9.14%. The detection rate of CRO increased first and then decreased in 8 years (P< 0.05). A total of 223 cases of nosocomial CRO infection occurred, and the incidence of infection was 0.06%. The incidence of nosocomial CRO infection had been decreasing for 8 consecutive years. After trend analysis, the difference was statistically significant (χ2=21.416, P<0.05). There were statistically significant differences in the incidence of nosocomial infection among patients of different genders and ages (P<0.05). The main pathogenic bacteria of CRO were CRAB, accounting for 77.08%. The departments were mainly distributed in critical care (58.74%) and brain surgery (27.80%). Respiratory tract infection (85.59%) was the main infection. Conclusions The continuous prevention and control of multi-drug-resistant bacteria can effectively reduce the occurrence and spread of nosocomial CRO infection, so the control of high-risk groups, high-risk departments and high-risk infection sites should be strengthened. |
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