老年病房患者多重耐药菌感染的调查

ANALYSIS OF MULTIDRUG- RESISTANT BACTERIA INFECTIONS IN THE GERIATRIC WARD

目的了解医院老年病房住院患者多重耐药菌感染特点,探讨有效防控措施。方法采用回顾性调查方法,对某医院老年病房住院患者多重耐药菌感染特征、病原菌分布以及危险因素进行调查。结果该医院老年病房在2年内共调查老年患者957例,发生多重耐药菌感染30例,感染率为3.14%,病死率70%。老年患者多重耐药菌感染以下呼吸道感染为主,其构成比达到66.67%。分离出的多重耐药菌主要是产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌、大肠埃希菌及耐碳青酶烯铜绿假单菌。病人的年龄、基础疾病、住院时间、侵入性操作、激素使用等构成感染的主要危险因素。结论该医院老年患者多重耐药菌感染率较高,以下呼吸道感染最多见,免疫力的改善、无菌技术保障和合理使用抗菌药物为主要防控措施。

Objective To study the clinical features of multidrug- resistant bacteria infection in the geriatric wards,so as to explore the effective measures for prevention and control. Methods The retrospective investigation was used to analyze multi- resistant bacteria infection characteristics,pathogen distribution and risk factors of the inpatients in geriatric ward of a hospital. Results 957 elderly patients in the hospital geriatric ward were investigated in 2 years. 30 cases occurred multidrug- resistant bacteria infection and the infection rate was 3. 14%,the mortality was 70%. Most of them were lower respiratory tract infections and the constituent ratio was 66. 67%. The main pathogens included ESBLs- produing Escherichia coli,Klebsiella pneumoniae and Carbapenems- resistant Pseudomonas aeruginosa. The risk factors of multidrug- resistant bacteria infection were age,disease kind and extent,hospitalization,invasive operation and glucocorticoid using,et al. Conclusion The infection rate of the elderly patients with multiple drug- resistant bacteria is higher and the low respiratory tract infections are the most common. The improvement of immunity,aseptic technique and rational use of antimicrobial agents are the keys to control multidrug- resistant bacteria infection.