某综合医院2017年多重耐药菌感染监测结果分析

Analysis on the Monitoring Results of Multiple Drug-resistant Bacteria Infection in a General Hospital in 2017

目的对某医院2017年多重耐药菌(MDRO)感染情况进行分析,为临床合理使用抗菌药物治疗及采取针对性的防控措施提供参考。方法对某医院2017年MDRO感染情况进行统计分析。结果1596株病原菌中MDRO检出率为5.5%,多重耐药鲍曼不动杆菌(MDR-AB)、耐甲氧西林金黄色葡萄球菌(MRSA)及多重耐药铜绿假单胞菌(MDR-PA)占前3位,分别为33.0%、30.6%、25.0%;未检出耐万古霉素肠球菌(VRE)。MDRO感染标本中以痰液和分泌物最为多见,分别占52.3%、34.1%;感染病区主要分布在ICU、神经外科和普通外科,构成比分别为30.7%、18.2%、12.5%。MDRO对临床常用抗菌药物耐药严重,革兰阴性杆菌对阿米卡星耐药率低,对其他抗菌药物耐药严重;MRSA对万古霉素、替加环素和利奈唑胺100.0%敏感,对青霉素、红霉素、克林霉素等抗菌药物耐药率>80.0%。结论该医院MDRO感染以MDR-AB、MRSA、MDR-PA多见,MDRO主要引起下呼吸道感染,ICU、神经外科和普通外科患者是MDRO感染的高危人群,医院应加强MDRO感染的监控和严格执行消毒隔离措施,避免MDRO医院感染的暴发流行。

Objective To provide the reference for clinical rational use of antimicrobial drugs and take corresponding prevention and control measures by analyzing the multi-resistant bacteria (MDRO) infections in a hospital in 2017. Methods The infection of MDRO in a hospital in 2017 was statistically analyzed. Results The detection rate of MDRO was 6.1%, and the most common ones were multi-drug resistant Acinictobacter baumannii (MDR-AB), methoxicillin resistant Staphylococcus aureus(MRSA) and multi-drug resistant Pseudomonas aeruginosa (MDR-PA), which were 33.0%, 30.6% and 25.0% respectively. Vancomycin-resistant Enterococcus(VRE )was not detected. Sputum and secretion in MDRO infection samples accounted for 52.3% and 34.1% respectively. The disease areas were mainly distributed in ICU, neurosurgery and general surgery, with a composition ratio of 30.7%, 18.2% and 12.5% respectively. MDRO is highly resistant to commonly used antibacterial drugs in clinical practice. Gram-negative bacillus has a low drug resistance rate only to Amikacin, and is seriously resistant to other antibacterial drugs. MRSA is sensitive to vancomycin, tigaricycline and linazolamine by 100.0%, and resistant rate to penicillin, erythromycin and clindamycin by>80.0%. Conclusion The MDRO infection in this hospital is mainly caused by MDR-AB, MRSA and MDR-PA, and MDRO mainly causes lower respiratory tract infection. Patients in ICU, neurosurgery and general surgery are at high risk of MDRO infection. The hospital should be strengthen the monitoring of MDRO infection and strictly implement disinfection and isolation measures, to prevent the outbreak of MDRO in hospitals.