口腔医院住院患者多重耐药菌医院感染监测

目的加强多重耐药菌感染管理,监测某口腔专科医院住院患者多重耐药菌(MDRs)感染的情况,为口腔专科医院住院病区预防和控制多重耐药菌感染以及制定隔离措施提供依据。方法对某口腔专科医院住院病区2010年1月1日至2011年12月31日共检出的70例次多重耐药菌病例的临床特征和病原菌种类进行回顾性分析。结果多重耐药菌检出病例占同期住院总人次数的0.79%,其中院内感染34例次,社区感染36例次,感染部位仅涉及手术切口和肺部,感染率分别为68.57%和31.43%。多重耐药菌病例发生与疾病种类、外伤史、外院住院史等相关,多重耐药菌分离出13种病原体,主要病原体为产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌(KPN)、耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林表皮葡萄球菌(MRSE)和ESBLs大肠埃希菌(ECO)、多重耐药铜绿假单胞菌等。结论要提高医务人员对多重耐药菌早期识别的能力,加强对社区感染病例的监测,特别是有外伤史和戴气管套管的患者,尽早将分泌物或痰送细菌培养,做好预防;要督促医院相关科室定期发布耐药菌变迁及药敏结果,以便医务人员根据结果更好地选择抗菌药物;要增强医务人员手卫生意识,及时对已发现的多重耐药菌感染采取隔离措施。

Surveillance of Multidrug-resistant organisms infection in stomatologcal hospital

Objective To find out the situation of multi-drug resistant（MDR） organism infection in inpatients of stomatological hospital in order to provide the basis for prevention.Methods The clinical data of 71 cases with MDR organism infection in a hospital of stomatology during January 2010 to December 2011 were retrospectively analyzed for clinical features and kinds of pathogens.Results The number of cases infected with multi-resistant organisms accounted for 0.8% including 35 cases of nosocomial infection and 36 cases of community infection.Sites of infection were only involved operation incision and lungs,and the infection rates were 69% and 31% respectively.The occurrence of multi-resistant organism infection was related to some kinds of diseases such as history of trauma,history of hospitalization etc.There were 13 species of MDR organisms isolated,and the main pathogens were extended-spectrum β-lactaminases（ESBLs） producing Klebsiella pneumoniae（KPN）,methicillin-resistant Staphylococcus aureus（MRSA）,methicillin-resistant Staphylococcus epidermidis（MRSE） and ESBLs producing Escherichia coli（ECO） etc.Conclusion The incidence of MDR organism infections in wards of stomatological hospital was low,but its increasing trend should be taken seriously consideration and to strengthen the surveillance of community infection,especially in patients with the history of trauma and tracheal cannulation should be on the alert.They need to be sent for bacterial culture of sputum as soon as possible.