ICU多药耐药菌感染分析与感染控制

Multidrug-resistant bacteria infections in ICU and control measures

目的对ICU多药耐药菌感染进行分析,探讨预防和控制多药耐药菌感染的控制措施。方法对2011年医院ICU 83例多药耐药菌感染情况进行分析,了解病原菌种类、数量、感染部位。结果 83例多药耐药菌感染患者中共培养出367株多药耐药菌,位居前3位细菌依次为鲍氏不动杆菌、肺炎克雷伯菌和铜绿假单胞菌,分别占42.51%、29.70%、8.45%;多药耐药菌主要分布在呼吸道,284株占77.38%,其余部位依次为血液、器官/腔隙、切口、导管、泌尿道、肠道,分别占9.26%、4.90%、4.09%、2.18%、1.91%、0.27%。结论采取完善耐药菌监测机制、开展ICU医院感染目标性监测、进行教育培训、保障设施设备、严格执行消毒隔离、合理使用抗菌药物等感染控制措施能有效预防和控制多药耐药菌在医院内的流行和暴发。

OBJECTIVE To analyze the multidrug-resistant bacteria infections in ICU and explore the control measures for the prevention and control of multidrug-resistant bacteria infections. METHODS Totally 83 cases of patients with multidrug-resistant bacteria infections in ICU were enrolled in the study, then the species of pathogens, quantities, and the infection sites were analyzed. RESULTS A total of 367 strains of multidrug-resistant bacteria were cultured from 83 patients, among which the Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudo- monas aeruginosa ranked the top three species, accounting for 42.51%, 29.70%, and 8.45%, respectively. Of the mutldrug--resistant bacteria isolated, there were 284 （77.38%） strains isolated from the respiratory tract, 9. 26% from blood, 4. 90% from organ/lacuna,4.09% from incision,2.18% from catheter, 1. 91% from urinary tract, and 0.27% from intestinal tract. CONCLUSION It is an effective way to take sound monitoring system of drug resistance, conduct the targeted monitoring of nosocomial infections in ICU, carry out the training, ensure the facilities and equipments, strictly implement the disinfection and isolation measures, and reasonably use antibi- otics so as to effectively control the outbreak and spread of the multidrug-resistant bacteria.