三级综合医院多药耐药菌感染监测分析

Surveillance of multidrug-resistant bacteria infections in a tertiary general hospital

目的了解多药耐药菌感染在三级综合医院分布特征及规律,为有效预防控制多药耐药菌医院感染提供依据。方法采用Phonenix100全自动细菌鉴定仪进行病原菌菌种鉴定,回顾性调查2013年全年医院多药耐药菌感染患者的临床资料,应用WHONET5.4软件进行统计描述和分析。结果全年共检出目标菌3 115株,多药耐药菌为541株,占17.37%,以多药耐药鲍氏不动杆菌感染最为多见,其次为耐甲氧西林金黄色葡萄球菌;其中,男性患者明显多于女性,并且以高龄和低龄患者居多,年龄≥60岁老年患者占36.78%,而年龄≤1岁婴儿占10.17%;多药耐药菌前3位标本来源分别为呼吸道、创面分泌物和尿标本,其中呼吸道标本占56.56%;呼吸道标本和尿标本中均以多药耐药鲍氏不动杆菌最多,创面分泌物中则以耐甲氧西林金黄色葡萄球菌最多;多药耐药菌感染患者多数分布在ICU中,占全部菌株的34.38%。结论多药耐药菌感染分布较广,应高度重视多药耐药菌感染的预防控制工作,从整体上预防、控制耐药菌的产生和传播。

OBJECTIVE To understand the distribution of multidrug-resistant bacteria infections in a tertiary general hospital so as to provide guidance for effective control of nosocomial infections caused by the multidrug-resistant bacteria. METHODS The identification of pathogens was performed by using Phonenix100 automatic bacteria iden- tification system, then the clinical data of the patients with multidrug-resistant bacteria infections were retrospec- tively investigated in 2013, and the statistical analysis was performed with the use of WHONET5.4 software. RESULTS A total of 3 115 strains of targeted bacteria have been isolated in the whole year, among which there were 541 （17.37 % ） strains of multidrug-resistant bacteria; the multidrug-resistant Acinetobacter baumannii was the most common species, followed by the methicillin-resistant Staphylococcus aureus. The male patients were sig- nificantly more than the female patients% the patients aged more than 60 years otd accounted for 36.78%, while the infants aged less than one year old accounted for 10.17%. The respiratory tract specimens, wound secretions, and urine specimens ranked the top three specimens sources from which the multidrug-resistant bacteria were isola- ted, and the respiratory tract specimens accounted for 56. 56%. The majority of the multidrug-resistant A. bau- mannii strains were isolated from the respiratory tract specimens and the urine specimens. Most of the cases of multidrug-resistant bacteria infections were in the ICU, accounting for 34. 38%. CONCLUSION The multidrug-re- sistant bacteria infections are widely distributed, and it is necessary to pay high attention to the prevention and control of multidrug-resistant bacteria infections so as to prevent the transmission of the drug-resistant strains as a whole.