Knowledge of Hospital Acquired Infections (HAIs) among Medical Students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria

Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.

Strategy and technology to prevent hospital-acquired infections:Lessons from SARS,Ebola,and MERS in Asia and West Africa

Hospital-acquired infections(HAIs) are serious problems for healthcare systems, especially in developing countries where public health infrastructure and technology for infection preventions remain undeveloped. Here, we characterized how strategy and technology could be mobilized to improve the effectiveness of infection prevention and control in hospitals during the outbreaks of Ebola, Middle East respiratory syndrome(MERS), and severe acute respiratory syndrome(SARS) in Asia and West Africa. Published literature on the hospital-borne outbreaks of SARS, Ebola, and MERS in Asia and West Africa was comprehensively reviewed. The results showed that healthcare systems and hospital management in affected healthcare facilities had poor strategies and inadequate technologies and human resources for the prevention and control of HAIs, which led to increased morbidity, mortality, and unnecessary costs. We recommend that governments worldwide enforce disaster risk management, even when no outbreaks are imminent. Quarantine and ventilation functions should be taken into consideration in architectural design of hospitals and healthcare facilities. We also recommend that health authorities invest in training healthcare workers for disease outbreak response, as their preparedness is essential to reducing disaster risk.

Hospital Acquired Infections in Low and Middle Income Countries: Root Cause Analysis and the Development of Infection Control Practices in Bangladesh

Nosocomial or hospital acquired infections are a major challenge for low and middle income countries (LMICs) which have limited healthcare resources. Risk factors include the lack of appropriate hospital facilities such as isolation units, bed space, and sinks;inadequate waste management, contaminated equipment, inappropriate use of antibiotics and transmission of infection from the hands of healthcare workers and family caretakers due to inadequate hand washing. Nosocomial infections increase the costs of healthcare due to added antimicrobial treatment and prolonged hospitalization. Since the prevalence of nosocomial infections is generally higher in developing countries with limited resources, the socio-economic burden is even more severe in these countries. This review summarizes the current knowledge on the risks of hospital acquired infections and summarizes current recommendations for the development of hospital infrastructure and the institution of protocols to reduce these infections in LMICs such as Bangladesh.

Prevalence and Potential Risk Factors of Hospital Acquired Extended-Spectrum Beta-Lactamase—Producing <i>Proteus</i>Species

Background: Multidrug resistance and production of extended spectrum β-lactamases (ESBLs) by a large group of bacterial agents in hospitals are to be a matter of scientific concern. Objective: This cross-sectional study was aimed to investigate the prevalence of ESBL producing Proteus species and risk factors associated with hospital acquired infection in addition to study the antibiotics susceptibility patterns of all bacterial isolates from inpatients of four Yemeni general hospitals. Methods: A total of 740 consecutive non-repeat culture isolates were obtained from admitted patients of Al-Kuwait University Hospital, Al-Thowra General Hospital, Al-Jumhori Teaching Hospital, and Military General Hospitals Sana’a city. We used Kirby-Bauer disk diffusion method to detect antimicrobial susceptibility and establish the presence of ESBLs-producing bacteria according to the Clinical and Laboratory Standards Institute guidelines. Results: Out of 740 isolate, 233 (31.5%) were Escherichia coli followed by Staphylococcus aureus 188 (25.4%), Pseudomonas aeruginosa 149 (20.1%), Klebsiella sp. 107 (14.5%), Enterococcus faecalis 25 (3.4%) and Proteus spp. 38 (5.1%). The highest frequencies of ESBLs producing among Proteus sp. were Proteus mirabilis 26 out 38 (68.4%) and Proteus vulgaris 12 out 38 (31.6%). The most effective of antimicrobial susceptibility pattern among Proteus spp. were Imipenem (100%) followed by Pipracillin-Tazobactam (92.3%) for P. mirabilis and (83.3%) for P. vulgaris, while the Amikacin (80.8%) for P. mirabilis and P. vulgaris with (91.7%). Amoxicillin and Cefotaxime were the highest for both species (100%). Conclusion: The prevalence of ESBL-producing Proteus spp. detected in this study is of great concern for public health authorities and a strict adherence of infection control policies and procedures with continuous antibiotics resistance surveillance including antimicrobial management and routine detection of ESBL-producing isolates are very important to prevent nosocomial infections.

Importance of Bacteriophage in Combating Hospital-Acquired Infection (HAI)

Bacteriophages have a potentially important role to play in reducing the global incidence of Hospital Acquired Infection (HAI). Their use should be focused on reducing the use and over-use of antibiotics as part of integrated control measures in conjunction with various vaccination, sanitation procedures and prophylactic and treatment regimens. Bacteriophages offer exquisite specificity and efficacy in killing target bacterial strains, a phenomenon known for almost 100 years. However, their efficacy with respect to broad-spectrum antibiotics is poor due to the highly strain-selective nature of their killing and their rapid elimination from the body. Bacteriophage killing is a naturally-occurring process capable of limiting and eliminating bacterial populations in humans. This is achieved through exponential amplification of their number, if and when, they encounter a target bacterium. Unfortunately, processes employed for their commercial production today do not meet the same rigour as dictated for pharmaceutical products. Batch-to-batch reproducibility and molecular definition of target and phage strains must be demanded before their clinical use can become widespread. Elsewhere, historical data have demonstrated safety in humans beyond any doubt. Because patients continue to die in our healthcare centers internationally, the use of bacteriophage to help fight HAI should be reassessed. Here, relevant literature is reviewed.

Microbiological Contamination of Bed Linen and Staff Uniforms in a Hospital

Hospital linen is clearly recognized as a potential reservoir for microorganisms and could be a vector of disease transmission. The aim of this study was to isolate, count and identify fungi and bacteria from different kinds of clean and dirty linen in a hospital. Microbiological samples have been collected on clean bed linen (n = 200), dirty bed linen (n = 192) and staff uniforms (n = 192) by using contact plates. 55% of samples from clean bed linen were contaminated before contact with the patient, with a mean count of 3 cfu/25 cm2 (range: 1-117 cfu) when contaminated. Virtually all samples from dirty bed linen carried microorganisms, with a mean count of 23 cfu/25 cm2 (range 1-191 cfu). In addition, staff hospital uniforms showed the highest contamination rates in the study, with an average of 45 cfu/25 cm2 (range: 1-218 cfu). Microbial species were mostly bacteria commonly found in the environment or on human skin, such as staphylococci or micrococci. Nevertheless, 57% of the identified species may be opportunistic pathogens for humans, representing a risk for people with a deficient or weakened immune system, especially in cases of superinfection. Since contamination of linen seems to occur after washing, actively antimicrobial textiles would represent a valuable measure to prevent textiles from being a vehicle for transfer of microorganisms.

A report on infection dynamics of inducible clindamycin resistance of Staphylococcus aureus isolated from a teaching hospital in India

Objective:To investigate the infection of hospital-and community-acquired"erythromycininduced clindamycin resistant"strains or D-test positives of clinical isolates of Staphylococcus aureus(S.aureus)(with and without methicillin resistance)in a hospital.Methods:Strains of S.aureus isolated from clinical specimens were subjected to D-test and antibiotic profiling.Results:Of the total 278 isolates,140(50.35%)were D-test positives and the rest were D-test negatives.Further,of 140(100%)pesitives,87(62.14%)and 53(37.85%)strains were from males and females,respectively.Of 140(100%)pesitives,117(83.57%)were methicillin resistant S.aureus and23(16.42%)were methicillin sensitive S.aureus;of 140 strains,103(73.57%)strains front persons with and 37(26.42%)were without related infections;of 140 strains,91(65%)and 49(35%)were from hospital-and community-acquired samples,respectively.In 140 strains,118(84.28%)with comorbidities and 22(15.71%)without comorbidities cases were recorded;similarly,persons with prior antibiotic uses contributed 108(77.14%)and without 32(22.85%)positive strains.These binary data of surveillance were analyzed by a univariate analysis.It was evident that the prior antibiotic uses and comorbidities due to other ailments were the determinative factors in D-test positivity,corroborated by low P values,P=0.001 1 and 0.0024,respectively.All isolates(278)were resistant to17 antibiotics of nine groups,in varying degrees;the minimum of 28%resistance for vancomycin and the maximum of 97%resistance for gentamicin were recorded.Further,of 278 strains,only42(15.1%)strains were resistant constitutively to both antibiotics,erythromycin resistant and clindamycin resistant,while 45(16.2%)strains were constitutively sensitive to both antibiotics(erythromycin sensitive,and clindamycin sensitive).Further,of the rest 191(68.7%)strains were with erythromycin resistant and clindamycin resistant,of which only 140(50.35%)strains were D-test positives,while the rest 51(18.34%)strains were D-test negatives.Conclusions:In view of high prevalence of D-test positive S.aureus strains,and equally high prevalence of multidrug resistant strains both in community and hospital sectors,undertaking of D-test may be routinely conducted for suppurative infections.

Predictors of Clostridium difficile infection severity in patients hospitalised in medical intensive care

AIM:To describe and analyse factors associated with Clostridium difficile infection(CDI)severity in hospitalised medical intensive care unit patients.METHODS:We performed a retrospective cohort study of 40 patients with CDI in a medical intensive care unit(MICU)at a French university hospital.We include patients hospitalised between January 1,2007and December 31,2011.Data on demographics characteristics,past medical history,CDI description was collected.Exposure to risk factors associated with CDI within 8 wk before CDI was recorded,including previous hospitalisation,nursing home residency,antibiotics,antisecretory drugs,and surgical procedures.RESULTS:All included cases had their first episode of CDI.The mean incidence rate was 12.94 cases/1000admitted patients,and 14.93,8.52,13.24,19.70,and8.31 respectively per 1000 admitted patients annually from 2007 to 2011.Median age was 62.9[interquartile range(IQR)55.4-72.40]years,and 13(32.5%)were women.Median length of MICU stay was 14.0d(IQR 5.0-22.8).In addition to diarrhoea,the clinical symptoms of CDI were fever(>38℃)in 23 patients,abdominal pain in 15 patients,and ileus in 1 patient.The duration of diarrhoea was 13.0(8.0-19.5)d.In addition to diarrhoea,the clinical symptoms of CDI were fever(>38℃)in 23 patients,abdominal pain in 15 patients,and ileus in 1 patient.Prior to CDI,38patients(95.0%)were exposed to antibiotics,and 12(30%)received at least 4 antibiotics.Fluoroquinolones,3rdgeneration cephalosporins,coamoxiclav and tazocillin were prescribed most frequently(65%,55%,40%and 37.5%,respectively).The majority of cases were hospital-acquired(n=36,90%),with 5 cases(13.9%)being MICU-acquired.Fifteen patients had severe CDI.The crude mortality rate within 30 d after diagnosis was 40%(n=16),with 9 deaths(9 over 16;56.3%)related to CDI.Of our 40 patients,15(37.5%)had severe CDI.Multivariate logistic regression showed that male gender[odds ratio(OR):8.45;95%CI:1.06-67.16,P=0.044],rising serum C-reactive protein levels(OR=1.11;95%CI:1.02-1.21,P=0.021),and previous exposure to fluoroquinolones(OR=9.29;95%CI:1.16-74.284,P=0.036)were independently associated with severe CDI.CONCLUSION:We report predictors of severe CDI not dependent on time of assessment.Such factors could help in the development of a quantitative score in ICU’s patients.

Status and Progress in the Control of Infection in Chinese Hospitals

This paper summarizes the characteristics and control of hospital-wide infections as identified by domestic surveys and research studies. This review also provides references to establish the basis for the control and management of hospital-acquired infection. Hospitalacquired infections are mainly initiated by Gram-negative bacteria and mainly localize in the lower respiratory tracts of patients. The intensive care unit has the highest infection rate among all hospital departments. Infants and the elderly are the most susceptible groups of patients to infection. Hands are an important route of pathogen transmission. The abuse of antibacterial drugs is an important factor of hospital-acquired infection. To control hospital-acquired infections, a sound management system should be established. In addition, medical staff, especially newcomers and interns, must receive strengthened training to improve their knowledge of hospital-acquired infection. Hand hygiene and the rational use of antibacterial drugs should be emphasized.

Knowledge Attitude and Practice towards Infection Control Measures amongst Medical Students in a Medical Teaching Tertiary Care Hospital

Introduction: Health care associated infections (HAIs) are likely to be the most common complication of hospital care. World Health Organization (WHO) estimates these infections to occur among 7% - 12% of the hospitalized patients globally, with more than 1.4 million people suffering from infectious complications acquired in the hospital at any time. Keeping this in mind, the present study was conducted to delineate the level of knowledge, attitudes, and practices (KAP) for the use of proper disinfection procedures among the final year undergraduate medical students in a tertiary care hospital and teaching institute. Methodology: Present study was conducted at Government Medical College, Surat, a tertiary care hospital and teaching institute. The participants who gave consent were provided with a pre-tested questionnaire that included several questions on knowledge attitude and practices on hospital acquired infections and its control practices. Analysis of the answers was done based on KAP score. Result: 80 students who consented were included in the study. 75% of the study population had correct knowledge about the most common health care associated infections (HAIs), being infection of venous access, urinary tract infection, respiratory infections and surgical site infections, based on their current knowledge on hospital acquired infections. Majority of study participants agreed with the fact that the inappropriate application of disinfection procedures increases the risk for a health care worker of either acquiring or transmitting a HAI from/to a patient. >90% participants had a good attitude towards risk of getting or transmitting any infectious disease by a Health care worker (HCW) while working and the utility of the application of disinfection procedures during work would reduce the rates of HAI. Practices of the students towards disinfection during performance of certain medical procedures ranged from 10% to 88% of the times showing poor practices of the medical students in following disinfection practices. Conclusion: In the present study the knowledge of medical students for the most common cause of hospital acquired infection was satisfactory. The overall attitude of the students was satisfactory as the mean score was 8. The practices of the students for the application of disinfection during performance of certain medical procedures were also satisfactory, although time to time training and tutorials of these students can help in increasing their knowledge, attitude and practices.

Physical restraint use rate and total fall and injurious fall rates: An exploratory study in two US acute care hospitals

This exploratory study used archived hospital data to investigate the relationships between the percentage of patients with physical restraints and the total fall rate as well as the injurious fall rate per 1000 patient-days. The two tested research questions were 1) What is the relationship between the restraint use rate and the total fall rate? 2) What is the relationship between the restraint use rate and the injurious fall rate? The results showed that a higher restraint use rate was associated with a higher total fall rate, yet a lower injurious fall rate in adult inpatient acute care settings. In efforts for fall and injurious fall prevention, front-line managers need to balance the frequency and appropriateness of physical restraint use with optimizing patients’ physical activity. Future research should explore the cause–effect relationship between physical restraint use and consequent injurious fall incidents.

重症医学科特殊宿主——器官移植患者的医院感染预防

随着移植技术的普及,越来越多的终末期器官功能衰竭患者接受移植手术,此类患者大多需在重症医学科接受进一步监护治疗。由于器官移植患者存在免疫抑制,其发生医院感染的风险显著升高。因此,对于此类患者,需更严格地落实呼吸机相关性肺炎、导管相关血流感染、导管相关尿路感染、手术部位感染预防的集束化管理措施;同时,需要采用更严格的医院感染制度和人员管理策略。本文结合指南推荐意见及临床经验,围绕器官移植患者的医院感染预防展开论述,以期为重症医学科临床诊疗提供参考和借鉴。

北京市某综合医院成人社区获得性肺炎病原学结果分析

目的:了解北京市某综合医院成人社区获得性肺炎的病原体分布情况,为临床诊治和疾病防控提供参考依据。方法:2018—2019年选取在北京市某综合医院感染科就诊的成人社区获得性肺炎患者,采集病例的痰液样本,采用多重实时荧光定量PCR检测方法对样本进行多种呼吸道病原体检测,分析呼吸道病原体在不同年龄段患者和不同季节中的检出情况。结果:330例社区获得性肺炎患者中,有286例患者检出呼吸道病原体,检出率为86.67%,其中检出单纯细菌感染、肺炎支原体感染、病毒感染和肺炎衣原体感染患者分别为98例、47例、16例和2例。在123例样本中检出混合病原体,检出率为37.27%。混合病原体感染中以细菌合并肺炎支原体最为多见,其次是细菌合并病毒感染。呼吸道病原体检出前3位依次为肺炎链球菌、肺炎支原体和流感嗜血杆菌。18~59岁年龄段患者肺炎支原体检出率明显高于≥60岁年龄段患者。结论:北京市某综合医院成人社区获得性肺炎患者呼吸道感染病原体以肺炎链球菌、肺炎支原体和流感嗜血杆菌为主,且混合感染率较高,临床上要重视混合病原体感染,并合理选择抗感染药物。

急性淋巴细胞白血病患儿医院感染防控对策研究

目的探讨急性淋巴细胞白血病患儿医院感染的防控对策。方法选取2019年1月至2022年6月该院血液肿瘤科收治的282例急性淋巴细胞白血病住院患儿,将其随机分为对照组(n=138)、观察组(n=144),2组均实施常规治疗及护理措施,观察组增加预防医院感染防控对策,对比2组患儿医院感染率、感染部位及总体健康水平。结果对照组患儿共发生医院感染22例25例次,观察组共发生医院感染10例12例次,对照组、观察组患儿医院感染发生率分别为15.94%、6.94%,对照组、观察组患儿医院感染例次发生率分别为18.12%、8.33%,观察组患儿医院感染发生率、医院感染例次发生率均低于对照组,差异均有统计学意义(P<0.05);感染主要部位为上呼吸道,革兰阴性菌为主要感染病原菌;观察组生活质量(QOL)评分[(69.87±3.41)分]高于对照组[(63.88±3.09)分],差异有统计学意义(P<0.05)。结论对急性淋巴细胞白血病采取感染防控对策可有效降低患儿医院感染发生率,提高其总体健康水平,有效缓解负性情绪。

外科手术患者术后院内获得性肺炎发生的影响因素

目的探讨外科手术患者术后院内获得性肺炎(HAP)发生的相关影响因素。方法回顾性选择2020年1月至2023年2月在九江市第一人民医院行外科手术治疗的2824例患者临床资料,按患者术后是否发生HAP分为HAP组(31例)和非HAP组(n=2793例),分析外科手术患者术后HAP发生的相关影响因素。结果单因素分析结果提示,不同年龄、手术性质、麻醉方式、合并糖尿病、吸烟史、气管切开、留置胃管、手术时间>3 h与患者术后HAP发生率比较,差异有统计学意义(P<0.05);性别、手术切口类型、术中出血量、合并高血压与外科手术患者术后HAP发生无关,差异无统计学意义(P>0.05);经logistic回归分析显示,年龄≥60岁(β=0.899,OR=2.458,95%CI=1.205~5.011)、急诊手术(β=1.985,OR=7.279,95%CI=3.488~15.188)、全麻(β=2.739,OR=15.464,95%CI=2.106~113.569)、合并糖尿病(β=0.983,OR=2.672,95%CI=1.310~5.450)、吸烟史(β=1.150,OR=3.157,95%CI=1.537~6.484)、气管切开(β=1.043,OR=2.837,95%CI=1.331~6.047)、留置胃管(β=0.753,OR=2.123,95%CI=1.035~4.355)、手术时间>3 h(β=2.198,OR=9.006,95%CI=4.384~18.501)是外科手术患者术后HAP发生的高危因素(P<0.05)。结论外科手术患者术后易发生HAP,其发生受多种因素共同影响,临床可针对各因素制定相应的防治对策,可减少HAP发生。

重症医学科医院感染控制原则专家共识(2024)

重症患者是医院感染的高危人群,且医院感染会显著增加重症患者的死亡率和治疗成本,因此,在治疗原发疾病的过程中,严格防控新发医院感染是重症患者救治的重要组成部分。重症患者的救治涉及多个环节,需从理论、管理、教育、规范、监督等多个层面发挥合力作用,才能实现医院感染的有效防控,但目前医院感染防控尚缺乏统一的认识和规范。为此,2024年3月,国内多名重症医学、感染病学及医院感染相关专家共同探讨了重症医学科医院感染控制现状及其问题,并在参考国内外最新循证医学证据的基础上,形成了《重症医学科医院感染控制原则专家共识(2024)》,以期为重症医学科制订医院感染防控策略提供依据。

神经重症病房疑似耐碳青霉烯类肺炎克雷伯菌感染暴发的调查与控制

目的调查某院神经重症病房一起疑似耐碳青霉烯类肺炎克雷伯菌(CRKP)感染暴发的原因,查找传染源与传播途径,为预防和控制医院感染的发生提供依据。方法对某院神经重症病房2020年8月4日—8月20日发生的4例CRKP感染患者进行流行病学调查以及病房环境卫生学监测,采取综合措施控制暴发流行。结果4例发生CRKP感染的患者均为医院感染,且分离菌株药敏试验结果一致,为相同克隆株。通过环境卫生学监测,分别从病人床旁物品,吸引装置,氧疗仪,医务人员随身用品的标本中检出了相同克隆株,采取综合整改措施后,未再出现新发CRKP感染病例,随后多次进行物表采样,未再分离出CRKP菌株。结论神经重症病房环境物表污染,消毒环节不到位可能是导致此次CRKP疑似感染暴发的主要原因,及时识别暴发,启动暴发应急预案,制定整改措施是控制多重耐药菌医院感染暴发的重中之重。

重症医学科医院感染困境与破局

随着重症医学的不断发展,重症医学科的医院感染问题日益突显,进而造成了诸多严重不良后果。因此,厘清其关键环节及发生机制,探讨更合理和有效的体系化防控手段,对于减少重症医学科医院感染、降低救治成本、改善患者预后具有重要意义。除体系化防控措施外,还需通过多学科通力协作及行政部门的大力支持,严格落实医院感染防控的具体细节,才能使这一棘手问题得以妥善解决。

重症监护病房267株病原菌的分布特点及耐药性

目的 探讨重症监护病房267株病原菌的分布特点及耐药性。方法 收集2021年1月—2023年11月义乌市中心医院重症监护病房收治的180例发生医院获得性感染患者送检的180份标本,统计医院获得性感染患者感染部位、标本来源。分析患者:病原菌的分布特点,结合药敏评估结果对主要革兰氏阳性菌(金黄色葡萄球菌、表皮葡萄球菌)、革兰氏阴性菌(大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌)的耐药性进行分析。结果 180例发生医院获得性感染患者肺部感染、泌尿系统感染占比较高,送检标本中痰液、尿液标本占比较高。180份标本经病原菌培养后共检出267株病原菌,其中革兰氏阳性菌占比29.59%,革兰氏阴性菌占比67.04%,真菌占比3.37%。2021—2023年间革兰氏阳性菌、真菌检出率呈上升趋势,革兰氏阴性菌检出率呈降低趋势。金黄色葡萄球菌对利奈唑胺具有较高的敏感性,表皮葡萄球菌对莫西沙星和利奈唑胺具有较高的敏感性。大肠埃希菌、铜绿假单胞菌均对哌拉西林/他唑巴坦具有较高的敏感性,肺炎克雷伯菌对复方新诺明、亚胺培南、哌拉西林/他唑巴坦具有较高的敏感性。结论 重症监护病房收治的医院获得性感染患者中病原菌分布主要为金黄色葡萄球菌、表皮葡萄球菌、大肠埃希菌、铜绿假单胞菌及肺炎克雷伯菌,且对抗菌药物存在不同程度耐药,后续在临床用药选择中应当慎重,应优先考虑敏感性高的抗菌药物。

ICU患者肺炎克雷伯菌血流感染的特点、新型诊断及治疗方案研究进展

肺炎克雷伯菌(Kp)在重症监护室(ICU)中引起的血流感染(BSI)近年来因发病率和病死率的惊人上升而引起人们的关注。随着患者的增加以及大量研究的开展,目前临床上对ICU内Kp-BSI的特点有了更加深入的探究,而且宏基因组二代测序技术、微滴式数字PCR以及机器学习等新型病原学诊断技术的发展,为ICU内Kp-BSI病原学诊断开辟了新的视野。同时,新型抗生素的研发以及多种治疗措施的改进和实施有望降低ICU内Kp-BSI患者的病死率。故本文就ICU-Kp-BSI的发生特点、新型的诊断和治疗手段进行综述,并对今后研究方向进行展望,旨在为临床诊治ICU-Kp-BSI提供新思路。