医院感染相关细菌耐药的现状与对策

细菌耐药发展迅猛,严重威胁患者的健康和生命,是全球抗感染领域关注的重点问题.在外科领域,高危患者尤应密切关注.消化道屏障功能不全,条件致病菌异常增多;免疫功能低下或障碍,以致条件致病菌毒性和患者易感性相对增强;重症患者（尤其ICU患者）接受多种医疗护理措施,使得耐药菌易感机会增多;医务人员由于知识不足和对病情严重度的顾虑,不合理应用抗生素等均可导致耐药菌感染性增强,需引起高度关注.应通过对相关知识的认真学习,严格按照各项规定科学用药,杜绝抗生素的滥用,保护患者尤其是危重患者的消化道屏障和免疫功能;注重运用精细手术、通畅引流等专科技术,及时检测、发现感染致病菌给予靶向治疗;加强各项医疗护理技术的无菌操作等综合措施的监控,最大限度地防治、控制耐药菌的产生和传播,促进患者康复.

Present status and contermeasures of antibiotic resistance in hospital infection

The rapid development of bacterial resistance is a serious threat to the patients＇ life and health,and it＇s also a focus in the field of anti-infection in the world.Surgeons should pay special attention to the antibiotic resistance in highrisk patients.Many subjective and objective factors caused antibiotic resistance,including increase of conditional pathogenic bacteria due to the dysfunction of barrier of digestive tract; enhancement of virulence of bacteria and susceptibility of patients owing to dysfunctional and low immunity; increased risk of antibiotic resistance because of application of various medical and nursing measures for severe patients （especially patients in ICU） ; unreasonable application of antibiotics due to insufficient knowledge of the medical staff and the concern of disease severity.In order to prevent the prevalence of antibiotic resistance,scientific and medical treatment under a variety of provisions should be adopted to prevent the abuse of antibiotics; safeguard the gastrointestinal barrier and immune function of patients; use fine operation,drainage and other specialized technology and timely detect the pathogenic bacteria and give targeted therapy; aseptic manipulation of medical and nursing technology should be applied.