常见多重耐药菌临床分布特征及管理对策

Analysis of Clinical Distribution Characters of Common Multidrug-Resistant Organism and the Management Strategy

目的探讨临床常见多重耐药菌感染发生部位及分布特征,采取有效措施控制多重耐药菌医院感染的发生。方法统计2010年1月1日～12月31日我院住院患者各类标本鉴定到的常见多重耐药菌的发生率、对多重耐药菌的感染部位及病原菌分布特征进行统计分析。结果共调查常见多重耐药菌感染患者20例。其中,有3例属于医院感染,占15%,17例属于社区感染,占85%。感染发生部位以胃肠道多见。病原菌种类检出率由高到低依次为:大肠埃希菌EsBls(+)菌(60.00%)、AD大肠埃希菌EsBls(+)菌(20.00%)、耐甲氧西林金黄色葡萄球菌(15.00%)、鲍氏不动杆菌(5.00%)。并分析得出了常见多重耐药菌标本分布情况、临床分布特点及对常见抗菌药物的耐药结果。结论多重耐药菌的感染管理涉及医疗、护理、检验等多个学科,需要从诊断、用药、监测等方面采取有效措施进行监督和指导,以预防和控制多重耐药菌带来的医院感染。

Objective To explore the infectious regions and distribution characters of clinical common multidrug-resistant organism（MDRO）and adopt the effective measures to control the occurrence of MDRO.Methods From January 1st to December 31st 2010,the statistical analysis was performed on the morbidity of common MDRO identified from various specimens for the inpatients of our hospital,the infectious regions and the distribution characters of MDRO.Results Totally 20 cases of MDRO were investigated.Of them,3 cases were hospital infection,accounting for 15%;17 cases were community infection,accounting for 85%.The location of infection was mostly in gastrointestinal tract.The testing rate of organism was in the sequence from the top to low as：Escherichia coli（EsBls）（＋）（60.00%）,AD Escherichia coli EsBls（＋）（20.00%）,meticillin resistant Staphylococcus aureus（MRSA）（15.00%）and Acinetobacter baumannii（AB）（5.00%）.The common MDRO distributions,clinical distribution characters and the drug resistance of common anti-bacterial drugs were figured out in the analysis.Conclusion The disciplines such as medicine,nursing and examination are involved in the infectious managements of MDRO.It is required to have a supervision and instruction for the effective measures in terms of diagnosis,medication,monitoring and others.Consequently,the hospital infection induced by MDRO can be prevented and controlled.