多重耐药菌感染监测情况分析及防控对策

Analysis of Monitoring Condition of Multidrug Resistant Infections and the Prevention and Control Strategy

目的了解武汉市某三级中西医结合医院医院多重耐药菌患者感染的发生情况,细菌耐药性分析,通过监测数据提出医院多重耐药菌感染防控对策。方法对2015年1月~2015年12月医院检验科微生物室分离出的多重耐药菌及对药物敏感性数据进行汇总分析。结果该院危重病人、有创操作较多的重症医学科、神经外科;老年患者相对集中、住院时间相对较长的呼吸内科、神经内科等科室的患者更容易发生多重耐药菌感染。MDROs感染病原菌复杂,耐药性严重,多种抗生素的联合使用和长时间抗菌药物是MDROs感染的高危因素。结论将MDROs纳入医院危急值管理、缩短住院时间、减少有创操作、重视抗菌药物的合理应用,严格落实消毒隔离及操作规程,院感办及多部门协同管理等措施,是减少医院多重耐药菌感染的有效手段。

Objective To explore the multi - drug resistant infections among patients in a Class Ⅲ Hospital of TCM and Western Medicine in Wuhan, analyze the bacterial drug resistance and propose the interventional measures by monitoring data. Methods The data of multi - drug resistance bacteria separated by the microbiology laboratory and drug sensitivity from January 2015 to December 2015 were analyzed. Results The patients from ICU and neurosurgery departments received invasive manipulations and those elderly patients staying longer in the departments of respiratory diseases and neurology were more susceptive multi - drug resistant infections. The complex MDROs pathogenic bacteria had severe drug resistance, with high risk factors of the combined use of a variety of antibiotics and the long time use of antimicrobial agents. Conclusion Putting the MDROs into hospital emergency management, shortening the hospitalization time, reducing invasive manipulation, paying more attention of rational use of antimicrobial agents, strictly implementing disinfection and operation procedures and managing along with multi - departments are the effective measures to reduce the multi - drug resistant infections in hospital.