某院神经内科住院患者近三年多重耐药菌感染趋势研究

Study on the trend of multidrug-resistant bacteria infection in hospitalized patients in a department of neurology in the past 3 years

目的:探讨我院神经内科住院患者近3年多重耐药菌感染趋势方法:对2017年3月〜2019年5月我院神经内科住院患者的多重耐药菌检出情况进行监测和分析:比较其多重耐药菌检出率、多重耐药菌感染部位构成情况以及多重耐药菌医院感染率结果:2017~2019年的多重耐药菌检出率呈逐年下降的趋势,分别是39.40%、34.46%和26.94%,有统计学意义(P<0.05).多重耐药菌感染率最高的三个部位分别是呼吸道感燊、泌尿系统感染以及胸膜腔感染,其中呼吸道感染连续3年均为主要感染部位,三年的感染率分别为60.23%、66.18%,、45.56%;泌尿系统感染三年的感染率分别为19.52%、17.03%、24.78%;胸膜腔感染三年的感染率分别为7.53%、6.99%、11.01%,差异具有统计学意义(P<0.05).较2017年和2018年相比,2019年的泌尿系统感染多重耐药菌所占比例为有所上升,数据具有统计学意义(P<0.05)2017~2019年ESBLs+大肠杆菌的医院感染率呈逐年下降的趋势,其三年的医院感染率分别为0.23%、0.21%、0.16%;多重耐药/泛耐药铜绿假单胞菌的医院感染率呈逐年上升的趋势,分别为0.22%、0.27%、0.25%,数据具有统计学意义2019年耐碳青霉烯类抗菌药物肠杆菌科细菌的医院感染率为0.02%,高于2017年的医院感染率0.01%和2018年的医院感染率0.00%(P<0.05).结论:本院多重耐药菌感染率最高的部位为呼吸道感染,且近三年的多重耐药菌检出率逐年下降,显著改善了多重耐药菌集中在医院感染中检出率高的现象,在医院感染的防控工作中应将呼吸道感染作为主要防控点.

Objective:To explore the trend of inultidrug-resistant bacterial infection in inpatients in neurology department in the past 3 years.Methods:Monitoring and analysis were conducted on the detection of multidrug-resistant bacteria among hospitalized patients in the department of Neurology of our hospital from March 2017 to May 2019.The detection rate,infection site composition and nosocomial infection rate of multidrug-resistant bacteria were compared.Results:The detection rate of multi-drug resistant bacteria from 2017 to 2019 showed a downward trend year by year,which were 39.40%,34.46%,and 26.94%,respectively,which was statistically significant(P<0.05).Respiratory tract infection,urinary tract infection and pleural cavity infection were the three sites with the highest rate of multidrug-resistant bacteria infecrion.Respiratory tract was the main infection site,of which infection rates for three consecutive years were 60.23%,66.18%and 45.56%,respectively.The infecrion rates of urinary tract for three years were 19.52%,17.03%,and 24.78%;the infection rates of pleural cavity infection for three years were 7.53%,6.99%,and 11.01%,and the differences were statistically significant(P<0.05).Compared with 2017 and 2018,the proportion of niultidrug-resistant bacteria in urinary system infection increased in 2019,and the data are statistically significant(P<0.05).From 2017 to 2019,the hospital infection rates of ESBLs+Escherichia coli have been decreasing year by year.Its three-year hospital infection rates were 0.23%,0.21%,and 0.16%,respectively;the nosocomial infection rate of multidRig-resistant/pan-drug-resistant Pseudomonas aeruginosa increased year by year,which was 0.22%,0.27%,and 0.25%,respectively,and the differences were statistically significant.The hospital infection rate of carbapenem-resistant Enterobacteriaceae in 2019 was 0.02%,which was higher than the hospital infection rate of 0.01%in 2017 and the hospital infection rate of 0.00%in 2018(P<0.05).Conclusion:The site with the highest infection rate of multidmg-resistant bacteria in our hospital is respiratory tract.The detection rate of mulridrug-resistant bacteria in the past three years decreased year by year.Nosocomial infection prevention and control should take respiratory infection as the main prevention and control point.