2004-2010年医院感染病原菌前瞻性监测结果分析

Prospective surveillance of pathogens causing nosocomial infection during 2004-2010

目的探讨医院感染病原菌的特点,为控制医院感染提供依据。方法对住院患者各种临床标本培养阳性结果进行前瞻性监测,定期总结分析反馈临床。结果 2004年1月-2010年12月共收治266 450例患者,其中8871例次发生医院感染,例次感染率为3.3%;共检出病原菌4408株,其中革兰阳性菌占18.7%,革兰阴性菌占53.7%,真菌占27.6%;病原菌医院感染部位以下呼吸道为主,占51.1%;医院感染主要病原菌为葡萄球菌属、大肠埃希菌、肺炎克雷伯菌(共1185株),1185株医院感染主要病原菌中,多药耐药菌(MDROs)感染检出683株,检出率为57.6%;MDROs医院感染部位以下呼吸道为主,占39.0%,其次为菌血症和泌尿道,分别为20.6%和15.1%。结论革兰阴性菌是医院感染的主要病原菌,下呼吸道、ICU医院感染多药耐药菌逐年增加;因此,MDROs监测工作应注重即时性和有效干预,应重点关注感染者消毒隔离措施执行的连续性,是减少多种耐药菌传播的重要环节。

OBJECTIVE To study the characteristics of the main pathogens of nosocomial infection,provide basis for the control of hospital infection.METHODS A variety of clinical specimens of hospitalized patients with culture-positive results of prospective monitoring,regular clinical feedback were analyzed.RESULTS A total of 266 450 cases of patients were treated from Jan 2004 to Dec 2010,of which 8871 cases occurred in nosocomial infection with the case-time infection rate of 3.3%.Totally 4408 strains were detected,of which the Gram-positive bacteria accounted for 18.7%,Gram-negative bacteria accounted for 53.7%,fungi accounted for 27.6%.The main pathogens were Staphylococcus,Escherichia coli,Klebsiella pneumoniae,a total of 1185 cases of times;multi-drug resistant bacteria（MDROs） hospital infection ratio 57.6%,MDROs the main site of infection accounted for 39.0% of lower respiratory tract,followed by bacterenia and urinary tract,accounting for 20.6% and 15.1%,respectively.CONCLUSION G-bacteria were the major pathogens causing nosocomial infection,Multidrug-resistant bacteria causing hospital infections in lower respiratory tract and ICU increase year by year.Therefore,MDROs monitoring should focus on immediate and effective interventions,concentrating on the continuity of disinfection and isolation measures is important to reduce the spread of multiple drug-resistant bacteria.