基层医院多药耐药菌感染目标性监测分析

Surveillance and analysis of multiple-drugs resistant organisms infection in local hospitals

目的了解基层医院多药耐药菌(MDROs)感染现状及分布特点,为临床治疗和合理制定医院感染预防控制措施提供依据。方法通过实验室信息系统(LIS)每日监控仙居县人民医院MDROs检出情况,并深入病房开展调查,对其临床分布特征进行统计分析。结果结果 2009-2010年住院患者中共检出金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌1 789株,其中MDROs菌株832株,占46.51%;感染患者主要分布于ICU,其次为神经内科及呼吸科,分别为53.04%、8.29%和7.45%;样本主要来源于痰,年龄≥60岁占首位;鲍曼不动杆菌的MDROs检出率高达71.36%,耐甲氧西林金黄色葡萄球菌、产超广谱β-内酰胺酶的肺炎克雷伯菌感染呈上升趋势。结论应加强对ICU、神经内科等重点科室的目标管理,预防和控制MDROs在医院内的传播。

Objective To better understand the current status and distribution of multiple-drugs resistant organisms（MDROs） in local hospitals,and to provide evidence for the prevention of clinical infection.Methods MDROs infection was monitored daily through Laboratory Information System（LIS） and clinical investigation was conducted among patients in Xianju local hospital for a period of 2 years.Results A total of 1789 strains were detected,including Staphylococcus aureus,Klebsiella pneumoniae,Escherichia col,Acinetobacter baumannii and Pseudomonas aeruginosa,of which 832 strains（46.51%） were found to be MDROs.Patients with MDROs infection were mainly from ICU（53.0%）,neurology department（8.29%） and respiratory department（7.45%） and most of them were over 60 years old.Sputum was the main specimen collected from patients.71.36% of MDROs were identified as Acinetobacter baumannii.This study also revealed that the infection rates of MRSA and ESBLs-producing Klebsiella pneumoniae were both gradually up.Conclusions Because most patients with MDROs infection were from ICU,neurology and respiratory departments,these departments should be the major targets for prevention and control of MDROs transmission in local hospitals.