产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌院内感染调查

目的 分析我院产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌院内感染情况。方法 调查我院2002年1月～2003年10月产ESBLs大肠埃希菌和肺炎克雷伯菌感染情况,分析其院内感染的特点及相关因素。结果 49例感染产ESBLs大肠埃希菌和肺炎克雷伯菌患者中社区获得性感染8例占16％,院内获得性感染42例占84％,院内感染科室有9个,主要是呼吸科、神经外科、消化科;院内感染部位主要是：呼吸道、泌尿道。院内感染患者100％前期应用抗菌素。结论 社区获得性感染产ESBLs大肠埃希菌和肺炎克雷伯菌患者入院,介入性操作,不合理应用抗菌素与我院产ESBLs大肠埃希菌和肺炎克雷伯菌院内感染有关,为控制其传播,应采取相应的消毒隔离措施,合理使用抗菌素,防止院内感染的暴发和流行。

Investigation for hospital infection induced by ESBL-production eescheria coli and klebsislla pneumonia strains

Objective To study hospital-acquired infection induced by ESBL-producing E. coli and K. pneumonia strain.Methods The survey was conducted in the hospital between January 2002 and October 2003, and the data collected included the incidence of the infection and some risk factors of hospital-acquired infection by ESBL-prodicting E. coli and K. pneumonia strains. Results Among 49 cases infected by ESBL-producing E. coli and K. Pneumonia strains, 42 cases were hospital-acquired infection (85.71%), and the other 7 cases were community-acquired infection (14.29%). The primary department with ESBL-prodictng E. coliand and K. Pneumonia infection was identified as respiratory diseases, nervous surgery and digestive diseases. Respiratory track and uninary track were the sites most often infected. 100% patients had the experience of previous use of antimicrobial.Conclusion Hospital-acquired infection is associated with the experiences the hospitalized patients had such as carry-over from community with the microorganisms of ESBL-producting E. coli and K. pneumonia strains, catheter therapy, and incorrect use of antimicrobial. It is important to use antimicrobial correctly. Disinfection and isolation measures should be enhanced for the infected patients in order to prevent any outbreak from the infection and decrease the possibility of the prevalence.