某专科医院住院患者多重耐药菌目标性监测分析

目的:了解医院多重耐药菌(MDRO)感染的耐药趋势,为临床合理应用抗菌药物和预防控制医院感染提供依据.方法:采用目标性监测方法对2011年3月1日至2012年8月30日住院患者检测出的所有耐甲氧西林金黄色葡萄球菌(MRSA)、耐万古霉素肠球菌(VRE)、产超广谱β-内酰胺酶(ESBLs)细菌、多重耐药/泛耐药铜绿假单胞菌(MDR/PDR-PA)及凝固酶阴性葡萄球菌(MRCNS)等进行监测.结果:共检出1 998株致病菌株,其中多重耐药菌为105株,占检出总致病菌株的5.3％.标本来源以痰液为主,主要为下呼吸道感染,肺结核病人感染率最高.耐药菌株以产ESBLs的细菌最多.年龄大、病程长、合并症多、接受侵入性操作、抗生素的使用等都是多重耐药菌感染的高危因素.结论:MDRO与多种危险因素有关,应加强医院感染管理,采取有效措施预防和控制MDRO在医院内的传播.

Objective surveillance of multidrug resistant bacteria on inpatients in a chest hospital

Objective To investigate the trend of multidrug--resistant organism （MDRO） infection and drug resistance, and with the aim of providing a basis for rational clinical use of antimicrobial drugs and the prevention and control of nosocomial infection. Methods Objective surveillance was used to monitor all the bacteria including methicillin-- re- sistant staphylococcus aureus （MRSA）, vancomycin-- resistant enterococci （VRE）, ESBLs-- producing bacteria, multi- drug-- resistant/pandrug -- resistant pseudomonas aeruginosa （MDR/PDR--PA） and methicillin resistant coagulase negative staphulococcus （MRCNS） which were detected in hospitalized patients with nosoeomial infection from Mar 1, 2011 to Aug 30,2012 in a chest hospital. Results Totally 1998 strains of pathogenic strains were detected in our study, including 105 strains of MDRO,and the rate was 5.3%. Specimen source was mainly phlegm,the lower respiratory tract was the major part of MDRO infection,and the infection rate was the highest in tuberculosis patients. ESBLs-- producing bacteria was the most in MDRO. Old age,long course of the disease,more complications,intrusive operations and the adoption of antibiotics were the risk factors of MDRO infection. Conclusion Due to the correlation between MDRO infection and multiple risk factors, we should strengthen the management of nosocomial infection and take some effective measures to control the spread of MDRO in hospitals.