多重耐药菌医院感染现状及预防控制措施

Hospital infection status and control measures of MDROs

近年来,随着广谱抗菌药物的研制开发和广泛使用,细菌耐药已成为国内外医院感染治疗的难题。多重耐药菌(MDROs)已经逐渐成为医院感染的重要病原菌且易造成暴发流行,交叉感染是MDROs主要的传播途径之一。MDROs医院感染受到越来越多的重视,其引发的医院感染发生率是评价医院预防控制措施和合理使用抗菌药物的一项重要的卫生学指标。采取多种干预措施可以有效降低MDROs医院感染发生率,措施包括:思想上充分重视;建立并不断完善MDROs的监测流程;加强MDROs医院感染患者的管理;加强医院环境卫生管理;加强对医护人员的教育和培训;实施MDROs目标性监测,逐渐完善MDROs监测报告体系,合理使用抗菌药物,降低感染率。存在问题:有些医院尚未建立有效的MDROs预防控制体系;甚至发生MDROs医院感染时怕受到上级管理部门的处罚而隐瞒不报;人力、物力资源不足;医院建筑布局无法满足快速增长的医疗需要;医务人员的教育、培训覆盖面不足等。要想取得良好的预防控制效果,需要医院各部门的相互配合、多方人员的共同努力和协作,降低MDROs医院感染的发生率。

In recent years,with the development and widely use of broad-spectrum antimicrobial agents,bacterial resistance has become a problem of nosocomial infection treatment at home and abroad.Multi-drug resistant organisms（MDROs） has gradually become the important pathogen of nosocomial infection and are easy to cause outbreaks.The main route of MDROs transmission is cross-infection.Hospital infection by MDROs has attracted more attentions.Multiple interventions,including ideologically full attention,establishing and improving monitoring,management of patients with MDROs nosocomial infection,health management of hospital environment,education and training of doctors and workers,MDROs targeted monitoring,improvement of MDROs report system,rational use of antibacterials,can effectively reduce the incidence of MDROs nosocomial infection？.But many problems exist,including lack of MDROs control system,concealed and unreported MDROs nosocomial infection due to afraid of upper management’s punishment,lack of human and material resources,unsatisfied fast-growing medical needs caused by current architectural composition,lack of training coverage.To achieve good control effect,mutual cooperation of various departments of the hospital and collaboration of multi-staff should be done to reduce the incidence of MDROs nosocomial infection.