结核病患者多重耐药菌感染临床分析及干预

摘要:目的　探讨结核病患者多重耐药菌（MDROs）的感染情况及危险因素，为防控提供科学临床依据。方法　对2012年1月至2013年12月住院的MDROs感染患者资料进行收集汇总分析。结果　2 098例住院结核病患者，检测出MDROs感染66例，感染例次85例，感染例次率为4.1%。感染部位以肺部感染为主，占94.1%，菌种分布为G+菌占60.0%；G-菌占31.8%。多重耐药菌感染高危因素与患者年龄大、机体免疫功能低下、病程长、合并有基础疾病、侵袭性操作、使用激素和免疫抑制剂、长期反复使用抗菌药物、治疗依从性差等因素有关。结论　重视高危人群和高危因素，建立有效监控制度，采取综合干预措施，可以避免感染暴发与流行。

Clinical analysis and intervention of multidrug-resistant bacterial infection in tuberculosis patients

Abstract: Objective This study was to explore the multidrug-resistant (MDR) bacterial infection situation and its risk factors in tuberculosis patient, in order to provide a scientific basis for the clinical tuberculosis prevention and control. Methods The data of hospitalized patients with MDR bacterial infections during January 2012 to December 2013 were collected and pooled for analysis. Results Among the 2098 hospitalized patients with tuberculosis, 66 were detected with MDR bacterial infections and 85 cases of infection occurred in total, with an infection rate of 4.05%. The majority (94.1%) of the cases were lung infections. Among the pathogenic bacteria, G+ bacteria accounted for 60.0%, G- bacteria accounted for 31.8%. The risk factors of multidrug-resistant bacterial infection included patient age, immune dysfunction, long term antibacterial treatment, hormone drug and immunosuppressant usage and so on. Conclusion Close attention should be paid to the high risk population. An effective monitoring system should be established. Comprehensive intervention measures should be taken to avoid MDR bacterial infection outbreak and epidemic.