肿瘤患者多重耐药菌医院感染分布特点及防控探讨

Distribution characteristics and discussion on prevention and control of nosocomial infection caused by multi-drug resistant bacteria in cancer patients

目的:了解广西医科大学附属肿瘤医院多重耐药菌(MDRO)分布特点,提出感染管理与预防控制措施。方法:回顾性分析2016年7月至2019年6月临床送检标本中分离出的MDRO监测资料。结果:共检出1101株MDRO,其中产超广谱β-内酰胺酶大肠埃希菌(ESBLs-ECO)检出最多(594株,占53.95%),其次为耐甲氧西林凝固酶阴性葡萄球菌(MRCONS)(205株,占18.62%);检出科室主要为妇瘤外科(168株,占15.26%),其次为重症监护病房(ICU)(157株,占14.26%)。MDRO标本来源主要以血液(303株,占27.52%)为主,其次是尿液(179株,占16.26%)。结论:该肿瘤医院MDRO感染最高为妇瘤外科;主要标本来源为血液;菌种为产超广谱β-内酰胺酶大肠埃希菌最高。应结合此特点有针对性的加强对高危科室及易感人群的防控,并制定有效的预防和控制措施,遏制MDRO的感染和传播。

Objective:To understand the distribution characteristics of multidrug resistant bacteria(MDRO)in a cancer hospital,and to put forward infection management and prevention and control measures.Methods:The monitoring data of MDRO isolated from clinical samples from July 2016 to June 2019 were retrospectively analyzed.Results:A total of 1101 MDRO strains were detected,of which 594 strains(53.95%)were escherichia coli producing extended-spectrum beta-lactamases(ESBLs-ECO),followed by methicillin-resistant coagulase-negative staphylococcus(MRCONS)(205 strains,18.62%).The detection department was mainly gynecological surgery(168 strains,accounting for 15.26%),followed by intensive care unit(ICU)(157 strains,accounting for 14.26%).The main source of MDRO specimens was blood(303 strains,27.52%)and urine(179 strains,16.26%).Conclusion:The highest MDRO infection in this tumor hospital is gynecologic surgery.The main source of specimens is blood.And escherichia coli producing extended-spectrum beta-lactamases is the highest strain.Combining this characteristic,we should strengthen the prevention and control of high-risk departments and susceptible groups,and formulate effective prevention and control measures to curb the infection and spread of MDRO.