某三甲综合医院2017~2018年多重耐药菌检出分布情况及高危因素分析

Distribution analysis and risk factors of multi-drug resistant bacteria in a tertiary general hospital from 2017 to 2018

目的:分析某三甲综合医院目标监测病原菌的具体检出情况及高危因素,为合理使用抗菌药物提供临床依据.方法:自2017年1月1日~2018年12月31日采用信息化监测与临床调查相结合的方式,对住院患者医院感染检出情况、多重耐药菌常见种类和分布科室及高危影响因素等进行回顾性分析总结.结果:2017~2018年共发生医院感染2799例,多重耐药菌感染3500例,院内感染有下降的趋势而多重耐药菌感染总例数有所上升;多重耐药菌分布科室以ICU及神经外科为主;最常见的耐药菌为鲍曼不动杆菌(32.61%);高龄(17.94%)、长期卧床(14.31%)、使用呼吸机(12.23%)是多重耐药菌感染前三位高危因素.结论:我院2018年多重耐药菌整体防控较2017年有所进步,但情况依旧严峻,应加强高危科室及高危因素的重点监管力度,从而提升医院感染管理水平.

Objective:To analyze of targeted multi-drug resistant bacteria(MDR)in our hospital from 2017 to 2018 so as to provide clinical evidence for rational use of antibacterial drugs in futher clinical practice.Methods:The pathogen distribution,clinical departments,specimen types and risk factors of multi-drug resistant bacteria in hospitalized patients were retrospectively analyzed by means of a combination of informatization monitoring and clinical investigation from January 1,2017 to December 31,2018.Results:From 2017 to 2018,there were 2799 cases of hospital infections and 3,500 cases of multi-drug-resistant bacteria infections.The number of nosocomial infections has decreased and the total number of multidrug-resistant bacteria infections has increased.Most of MDR isolates were distributed in the intensive care unit(ICU)and neurosurgery.The most common drug-resistant bacteria is Acinetobacter baumannii(32.61%).Elderly(17.94%),long-term bedridden(14.31%),and useing ventilator(12.23%).They are the top three high-risk factors for multidrug-resistant bacteria infection.Conclusion:The overall prevention and control of multidrug-resistant bacteria had been improved compared with 2017.but the situation is still severe.Multidisciplinary and multisectoral departments should jointly strengthen targeted monitoring to reduce the clinical incidence of multidrug-resistant bacteria in hospitals.