重症监护病房多重耐药感染情况及综合干预对策

Multiple drug resistance in intensive care unit and comprehensive intervention measures

目的观察分析重症监护病房(ICU)多重耐药感染的临床特点,以探讨防控ICU多重耐药感染的综合干预对策。方法回顾性分析2012年1月~2015年12月于我院治疗的288例ICU多重耐药感染患者的临床资料,分析多重耐药菌的检出率及分布情况。结果 2012~2015年我院共发生感染882例,其中多重耐药菌感染288例,占比32.65%,多重耐药菌感染发生率在这4年呈逐年上升趋势。288例患者共分离307株多重耐药菌,其中革兰氏阴性菌214株,占比69.71%,革兰氏阳性菌88株,占比28.66%。其中以鲍曼不动杆菌最多,占比27.04%,其次铜绿假单胞菌,占比14.66%。多重耐药菌感染部位以下呼吸道为主,占比53.13%,其次是泌尿系统,占比12.15%。结论 ICU多重耐药感染发生率呈逐年增加趋势,应当采取积极有效的综合干预对策控制和预防其传播。

Objective To observe and analyze the clinical characteristics of multiple drug-resistant infectionsin intensive care unit(ICU),and to explore the comprehensive intervention measures of ICU multi-drug infection.Methods The clinical data of288cases with ICU multidrug resistance in our hospital from January2012toDecember2015were retrospectively analyzed.The detection rate and distribution of multiple drug-resistant bacteriawere analyzed.Results There were882cases of infection in our hospital from2012to2015,including288cases ofmultidrug resistance occupied32.65%of total,the incidence of multiple drug-resistant infections increased year byyear in those four years.307strains of multiple drug-resistant bacteria were isolated from288patients,among themincluding214strains of gram-negative bacteria with percentage of69.71%,88strains of gram-positive bacteria withpercentage of28.66%.Among them,baumanii was the most with percentage of27.04%,followed by pseudomonasaeruginosa,with percentage of14.66%.Most of multiple drug-resistant happened in lower respiratory tract withpercentage of53.13%,followed by the urinary system with percentage of12.15%.Conclusion The incidence of ICUmultiple drug infection is increasing year by year.Positive and effective comprehensive intervention measures shouldbe taken to control and prevent its spreading.