肿瘤医院ICU患者多药耐药菌定植的监测研究

Surveillance of colonization of multidrug-resistant bacteria(MDROs) in ICU patients from cancer hospital

目的了解肿瘤医院ICU多药耐药菌(MDROs)定植特点,分析其危险因素,为临床治疗提供参考依据。方法对医院2014年12月-2015年12月入住ICU 168名患者经鼻前庭拭子和肛拭子采集标本,进行多药耐药菌的筛查。结果 470份标本中共分离出多药耐药菌116株:其中产ESBLs大肠埃希菌114株,占98.2%,产ESBLs肺炎克雷伯杆菌2株,占1.7%。多因素logistic回归分析显示,入ICU时APACHEⅡ评分及入ICU前抗菌药物的使用是患者入ICU前合并MDROs定植的独立危险因素(P<0.05)。结论重视MDROs的定植的高危因素,加强MDROs的预防控制,有效地预防医院感染。

OBJECTIVE To investigate the characteristics of colonization of multidrug-resistant bacteria（MDROs）in ICU patients from cancer hospital and analyze its risk factors,so as to provide references for clinical treatment.METHODS Nasal vestibular swab and anal swab specimens of 168 patients admitted to ICU from Dec.2014 to Dec.2015 were collected,and screened for multidrug-resistant bacteria.RESULTS Totally 116 strains of multi-resistant bacteria were isolated from 470 cases of specimens,with 114 strains of ESBLs-producing Escherichia coli isolates,2strains of ESBLs-producing Klebsiella pneumoniae,accounting for 98.2% and 1.7%.Multivariate logistic regression analysis showed that,APACHE Ⅱscore admitted to ICU and the use of antibiotics before admission to ICU were the independent risk factors（P〈0.05）for colonization of MDROs of patients before admission to ICU.CONCLUSION We should pay more attention to the risk factors of MDROs colonization and strengthen effective measures of MDROs to prevent nosocomial infection.