| 某综合性医院连续三年多重耐药菌感染特点分析 |
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| 引用本文： | 戴礼兰,施明美,张爱萍,胡钟,汪华学.某综合性医院连续三年多重耐药菌感染特点分析[J].中华全科医学,2021,19(3):502-504. |
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| 作者姓名： | 戴礼兰 施明美 张爱萍 胡钟 汪华学 |
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| 作者单位： | 1.马鞍山十七冶医院医院感染管理科，安徽 马鞍山 243000 |
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| 基金项目： | 安徽省重点研究和开发计划项目1804h08020256 |
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| 摘 要： | 目的 了解安徽省马鞍山十七冶医院2016年1月—2018年12月的多重耐药菌检出及分布情况。 方法 回顾性分析安徽省马鞍山十七冶医院2016年1月—2018年12月的临床送检标本中分离的多重耐药菌(MDROs)检测资料。 结果 2016—2018年间分别检出MDROs 314株、420株、359株，MDROs分离率为28.31%、35.35%、30.95%，差异有统计学意义(P < 0.05)。2017年及2018年分离出的病原菌中，MDROs所占比例均超过30.00%。2016—2018年产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌检出率分别为33.90%、67.54%、40.98%(P < 0.05)；耐甲氧西林金黄色葡萄球菌(MRSA)检出率分别为20.51%、19.09%、38.53%(P < 0.05)；多重耐药鲍曼不动杆菌检出率分别为68.42%、46.15%、45.24%(P < 0.05)，呈逐年下降趋势；耐碳青霉烯类肺炎克雷伯菌检出率分别为0.00%、5.26%、9.84%(P < 0.05)，呈逐年上升趋势。MDROs检出构成比最多的科室为内科，其次为ICU。其中，泌尿外科MDROs检出构成比分别为9.24%、9.76%、6.41%(P < 0.05)。脑外科MDROs检出构成比分别为1.59%、1.46%、5.57%(P < 0.05)。MDROs检出最多的标本类型依次为痰液、尿液及其他。 结论 MDROs检出率呈总体上升，尤其是耐碳青霉烯类肺炎克雷伯菌的分离率正逐年增加。应加强对MDRO感染的预防与控制管理，促进临床合理使用抗菌药物。
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| 关 键 词： | 多重耐药菌 耐药性 趋势 |
| 收稿时间： | 2020-05-11 |
Characteristics of multidrug-resistant organism infections in a hospital for three consecutive years |
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| Affiliation: | Department of Nosocomial Infection Management, the Hospital of China Seventeenth Metallurgical Group Co., Ltd., Ma'anshan, Anhui 243000, China |
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| Abstract: | Objective To explore the detection and distribution of multi-drug resistant organism (MDRO) in the Hospital of China Seventeenth Metallurgical Group Co., Ltd. Methods The monitoring data for MDROs isolated from clinical thesamples submitted by the hospital of China Seventeenth Metallurgical Group Co., Ltd. from 2016 to 2018 were analyzed retrospectively. Results From 2016 to 2018, 314 strains, 420 strains and 359 strains of MDROs were detected. The isolation rate of MDROs were 28.31%, 35.35% and 30.95%, with statistically significant difference (P < 0.05). MDROs accounted for more than 30.00% of the isolated pathogens in both 2017 and 2018. The positive rates of klebsiella pneumoniae producing ESBLs were 33.90%, 67.54% and 40.98% in 2016, 2017 and 2018, respectively (P < 0.05). The detection rates of Methicillin-resistant Staphylococcus aureus (MRSA) were 20.51%, 19.09% and 38.53% in 2016, 2017 and 2018 respectively (P < 0.05). The detection rates of Acinetobacter baumannii with multiple-drug resistance were 68.42%, 46.15% and 45.24% in 2016, 2017 and 2018, respectively (P < 0.05), showed a decreasing trend year by year. The detection rates of carbapenems-resistant Klebsiella pneumoniae were 0.00%, 5.26% and 9.84% in 2016, 2017 and 2018, respectively (P < 0.05), showing an increasing trend year by year. The department with the highest proportion of MDROs detection was internal medicine, followed by ICU. The composition ratio of MDROs in urology were 9.24%, 9.76% and 6.41%, respectively (P < 0.05). The composition ratio in brain surgery were 1.59%, 1.46% and 5.57%, respectively (P < 0.05). The most common types of specimens with high detection rates of MDROs were sputum, urine, and others. Conclusion The detection rate of MDROs showed an overall increase, especially the isolation rate of carbapenems-resistant Klebsiella pneumoniae was increasing year by year. The prevention, control and management of MDROs infection should be strengthened to promote the rational use of antibiotics in clinical practice. |
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