2010-2012年多药耐药菌医院感染的临床分析

Cause analysis of increased multidrug resistant bacteria in nosocomial infections from 2010 to 2012

目的探讨2010-2012年多药耐药菌医院感染的临床特点,为制定其引起医院感染的预防控制措施提供依据。方法选择2010-2012年57 363例住院患者临床资料,采用前瞻性与回顾性调查相结合的方法对343例多药耐药菌医院感染患者的临床资料进行调查分析,数据采用SPSS13.0统计软件进行处理。结果 57 363例住院患者中343例发生多药耐药菌感染,感染率为0.60%,2010-2012年多药耐药菌医院感染率分别为0.23%、0.55%、1.06%,呈逐年上升趋势,差异有统计学意义(P<0.01);痰液中检出多药耐药菌最多136株占39.65%,其次为尿液、分泌物,分别占28.28%、19.53%;检出前3位的多药耐药菌分别为大肠埃希菌、肺炎克雷伯菌及鲍氏不动杆菌,分别占55.98%、18.66%及5.54%;感染部位居前3位的分别为呼吸道、泌尿道及皮肤软组织,分别占39.36%、30.03%及8.45%;目标性监测标本200份,在媒介物中共检出18株多药耐药菌,检出率为9.00%。结论 2010-2011年多药耐药菌医院感染率呈逐年上升趋势,根据导致医院感染的相关因素,采取预防控制措施,可有效降低医院感染的发生,保障医疗安全。

OBJECTIVE To discuss the causes of increased multidrug resistant bacteria in nosocomial infections from2010 to 2012,and to explore the clinical characteristics of nosocomial infection caused by multidrug resistant bacteria,so as to guide the prevention and control.METHODS A total 343 medical records（from Jan.2010 to Dec.2012）of inpatients with secondary nosocomial infections caused by multidrug resistant bacteria were collected and analyzed by SPSS13.0.RESULTS From 2010 to 2012,the yearly nosocomial infection rates were respectively0.23%,0.55%and 1.06%,a rising trend with significant difference（P〈0.01）.Multidrug resistant bacteria were mainly found in sputum（39.65%）,followed by urine（28.28%）and secreta（19.53%）.The top three multi-drug resistant bacteria were Escherichia coli（55.98%）,Klebsiella pneumonia（18.66%）and Acinetobacter baumannii（5.54%）.The main infection sites were respiratory tract（39.36%）,urinary tract（30.03%）and skin soft tissue（8.45%）;from the targeted 200 surveillance specimens,18 strains of multidrug-resistant bacteria were detected（9.00%）.CONCLUSIONIn recent three years,nosocomial infections caused by multi-drug resistant bacteria increased year by year.Figuring out factors that may cause nosocomial infections can promote effective prevention and control and thus reduce the incidence of nosocomial infections and ensure medical safety.