某医院重症监护病房多重耐药菌目标监测结果分析

Analysis on monitoring results of multidrug-resistant bacteria in intensive care unit of a hospital

目的了解医院各重症监护病房(ICU)多重耐药菌的感染和耐药情况。方法通过回顾性分析方法,对2015年1月-2017年12月某医院8个ICU患者送检标本多重耐药菌病原检测结果进行统计分析。结果 3年间共检出7 908株病原菌,其中多重耐药菌有1 859株。耐药鲍曼不动杆菌检出率最高,其次是肺炎克雷伯菌。多重耐药菌主要分离自痰液。多因素Logistic结果显示,住院时间、抗菌药物使用及侵入性操作是多重耐药菌感染的危险因素。结论该院ICU多重耐药菌分离率较高,院内感染发生的常见部位是呼吸道。发生多重耐药院内感染的危险因子为有创机械通气、插导尿管、胃管、留置深静脉置管等侵入性操作、长时间住院及大量或长期使用抗菌药物等因素。

Objective To understand the infection and drug resistance of multidrug-resistant bacteria in intensive care units(ICU)of hospitals.Methods A retrospective analysis method was used to analyze the pathogenic detection results of multidrug-resistant bacteria of patients in 8 ICUs from January 2015 to December 2017 in a hospital.Results A total of 7908 strains of pathogens were detected in the past 3 years,of which 1 859 strains were multidrug-resistant.The drug-resistant Acinetobacter baumannii had the highest detection rate,followed by Klebsiella pneumoniae.Multidrug-resistant bacteria were mainly isolated from sputum.Multivariate Logistic results showed that hospitalization time,antibiotic use,and invasive manipulation were risk factors for multidrug-resistant infection.Conclusion The isolation rate of multidrug-resistant bacteria is high in the ICU of this hospital,and the common site of nosocomial infection is respiratory tract.The risk factors for multidrug-resistant nosocomial infection were invasive mechanical ventilation,catheterization,gastric tube,invasive manipulation such as indwelling deep vein catheterization,prolonged hospitalization,and large or long-term use of antibiotics.