某医院耐碳青霉烯类革兰阴性杆菌医院感染分布及其耐药性研究

Epidemiology characteristics and drug resistance of carbapenem-resistant organism hospital-acquired infection in a hospital

目的 研究医院耐碳青霉烯类革兰阴性杆菌(CRO)医院感染分布及其耐药性。方法 通过回顾性调查方法,对某医院CRO医院感染病例的临床资料和药敏结果进行分析。结果 共调查住院患者466 128例,查出CRO医院感染共488例,CRO医院感染率1.05‰。在488例CRO医院感染患者中,耐碳青霉烯类肠杆菌科(CRE)医院感染率为0.56‰,耐碳青霉烯类鲍曼不动杆菌(CRAB)医院感染率0.44‰,耐碳青霉烯类铜绿假单胞菌(CRPA)医院感染率0.04‰。CRO医院感染病例分布,ICU病房高于普通病房,外科系统高于内科系统。感染部位分布,呼吸系统感染占79.30%,其次是血液系统8.81%,泌尿系统7.58%,手术部位4.10%。临床分离的CRO只对替加环素、头孢曲松和头孢吡肟等敏感,对其他常见抗菌药物耐药率均比较高。结论 CRO医院感染以呼吸道感染为主,医院感染菌株对常见抗菌药物的耐药率普遍较高,应加强CRO监测和合理使用抗菌药物。

Objective To analyze the nosocomial infection distribution and drug resistance of carbapenem resistant organism(CRO).Methods The clinical data and drug sensitivity results of CRO nosocomial infection cases were retrospectively investigated in the hospital.Results 466 128 inpatients were investigated.48 cases had nosocomial infection with the infection rate of 1.05 ‰.The nosocomial infection rate of carbapenem resistant Enterobacteriaceae(CRE), Acinetobacter baumannii(CRAB),and Pseudomonas aeruginosa(CRPA) was 0.56‰, 0.44‰ and 0.04 ‰ respectively.The nosocomial infection rate of CRO in ICU was higher than that in general ward, and the nosocomial infection rate of CRO in surgical system was higher than that in medical system.Respiratory system infection accounted for 79.30% of CRO,followed by blood system infection 8.81%,urinary system infection 7.58% and surgical site infection 4.10%.Except piperacillin/tazobactam and cefepime, the drug resistance rates of CRPA hospital infection strains to other commonly used antibiotics were higher than those of carbapenem sensitive Pseudomonas aeruginosa(CSPA) in hospital.Conclusion The main nosocomial infection of CRO is respiratory tract infection.The resistance rates of CRO nosocomial infection strains to common antibiotics are generally high.We should strengthen the monitoring of CRO strains, use antibiotics scientifically and reasonably.