某院普通外科多重耐药菌感染综合干预效果

Efficacy of comprehensive intervention in infection due to multidrug-resistant organisms in the general surgery department of a hospital

目的调查某三甲医院普通外科多重耐药菌(MDRO)感染现状,了解综合干预措施的干预效果。方法对2015年3月—2016年10月入住该院普通外科>48 h的患者进行MDRO目标性监测,2016年1月起采取综合干预措施,比较干预前后MDRO感染情况。结果2015年3月—2016年10月收治的住院患者6 406例,MDRO感染155例(2.42%),感染部位以腹腔(积液、胆汁)(76例,49.03%)和手术部位感染(43例,27.74%)为主。干预前(2015年3—12月)MDRO感染率为2.79%(99/3 549),干预后(2016年1—10月)下降至1.96%(56/2 857)(χ2=4.612,P=0.032)。干预后MDRO病原菌无明显变化,均以大肠埃希菌为主。结论采取综合干预措施可以降低该院普通外科MDRO感染发病率。

ObjectiveTo investigate the current status of multidrugresistant organism （MDRO） infection in the general surgery department of a tertiary firstclass hospital, and understand the efficacy of comprehensive intervention measures. MethodsTargeted monitoring on MDROs was implemented among patients who were hospitalized in a general surgery department for〉48 hours between March 2015 and October 2016, comprehensive intervention measures were taken since January 2016. MDRO infection before and after intervention was compared. ResultsBetween March 2015 and October 2016, a total of 6 406 hospitalized patients were monitored, 155（2.42%） developed MDRO infection. The most common infection sites were abdominal cavity（hydrops, bile） （n=76, 49.03%） and surgical site （n=43, 27.74%）. MDRO infection rate dropped from 2.79% （99/3 549） before intervention （MarchDecember, 2015） to 1.96% （56/2 857） after intervention （JanuaryOctober, 2016） （χ2=4.612, P=0.032）. There was no difference in MDROs between before and after intervention, the major were both Escherichia coli. ConclusionComprehensive intervention measures can reduce the incidence of MDRO infection in the general surgery department of this hospital.