泸州某医院手术室多重耐药菌感染现状研究

Study on multi-drug resistant bacteria infection in operating room of a hospital in Luzhou

目的分析某医院手术室患者多重耐药菌(MDRO)感染现状,找出相关因素。方法选择2020年2月至2021年1月泸州某医院手术室12619例成年患者作为研究对象,调查患者资料,进行病原菌检测和细菌药敏试验,统计手术室MDRO感染发生情况,分析MDRO感染的菌种、科室分布、耐药情况和MDRO感染发生的相关因素。结果医院手术室患者MDRO感染发生率为2.10%。MDRO感染占比较大的科室是普外科(34.28%)、骨科(23.78%)、泌尿外科(15.22%)。手术室患者MDRO感染中较常见的菌种是鲍曼不动杆菌(46.99%)、金黄色葡萄球菌(19.91%)、铜绿假单胞菌(12.04%)。鲍曼不动杆菌对头孢曲松完全耐药,对氨苄青霉素、环丙沙星、头孢他啶、头孢吡肟、庆大霉素、妥布霉素耐药率超过80.00%,仅对左氧氟沙星耐药率不超过30.00%;金黄色葡萄球菌对青霉素、苯唑西林完全耐药,对红霉素、氯林可霉素的耐药率超过80.00%;铜绿假单胞菌对头孢曲松、氨苄青霉素完全耐药,对头孢他啶、环丙沙星、复方新诺明耐药率超过80.00%,仅对阿米卡星耐药率不超过30.00%。Logistic回归分析结果显示,入住ICU(OR=5.943)、侵入性操作(OR=2.704)、抗菌药物使用时间长(OR=2.244)、合并糖尿病(OR=1.955)是医院手术室患者MDRO感染的影响因素。结论泸州某医院手术室患者MDRO感染发生率较高,可能受入住ICU、侵入性操作、抗菌药物使用时间长、合并糖尿病的影响。

Objective To analyze the current situation of multi-drug resistant bacteria(MDRO)infection in operating room of hospital,and to find out its related factors.MethodsA total of 12619 adult patients in the operating room of a hospital in Luzhou from February 2020 to January 2021 were selected as the research object.The data of patients were investigated,the pathogen detection and bacterial drug sensitivity test were carried out,the incidence of MDRO infection in the operating room was counted,and the strains,department distribution,drug resistance and related factors of MDRO infection were analyzed.ResultsThe incidence rate of MDRO infection in the operating room was 2.10%.The major departments with MDRO infection were general surgery(34.28%),orthopedics(23.78%)and urology surgery(15.22%).The common strains of MDRO infection in operating room were Acinetobacter baumannii(46.99%),Staphylococcus aureus(19.91%)and Pseudomonas aeruginosa(12.04%).Acinetobacter baumannii was completely resistant to ceftriaxone,the resistance rates to ampicillin,ciprofloxacin,ceftazidime,cefepime,gentamicin and tobramycin exceeded 80.00%,and the resistance rate to levofloxacin was less than 30.00%.Staphylococcus aureus was completely resistant to penicillin and oxacillin,the resistance rates to erythromycin and clindamycin exceeded 80.00%.Pseudomonas aeruginosa was completely resistant to ceftriaxone and ampicillin,the resistance rates to ceftazidime,ciprofloxacin and compound sulfamethoxazole exceeded 80.00%,and the resistance rate to amikacin was less than 30.00%.Logistic regression analysis showed that admission to ICU(OR=5.943),invasive operation(OR=2.704),long duration of antibiotic use(OR=2.244),and diabetes mellitus(OR=1.955)were the influencing factors of MDRO infection in operation room.ConclusionThe incidence of MDRO infection in the operation room of a hospital in Luzhou is high,which may be affected by admission to ICU,invasive operation,long duration of antibiotic use and diabetes mellitus.