恶性肿瘤患者多重耐药菌医院感染监测

目的了解恶性肿瘤患者多重耐药菌(MDRO)医院感染情况,为临床制定医院感染预防控制措施提供依据。方法采用目标性监测方法监测2014年1月1日—12月31日某院恶性肿瘤住院患者的MDRO医院感染情况,应用WHONET5.3软件对数据进行统计分析。结果共调查恶性肿瘤患者54 056例,发生医院感染3 542例,医院感染发病率为6.55%;其中MDRO医院感染847例(占23.91%)。MDRO医院感染患者以60岁为主(54.55%)。医院感染病例共检出细菌2 606株,其中MDRO菌株847株,占32.50%,以产超广谱β-内酰胺酶(ESBLs)大肠埃希菌为主(459株,占54.19%)。MDRO医院感染部位以下呼吸道为主(47.34%)。MDRO检出科室居前3位的依次为胸外科(17.12%)、结直肠肛门外科(9.92%)及普外科(8.26%)。结论恶性肿瘤患者MDRO医院感染发病率较高,应加强高危人群的监控及病原菌耐药性的监测,减少MDRO医院感染的发生。

Surveillance on multidrug resistant organism infection in patients with malignant tumor

ObjectiveTo understand multidrug resistant organism (MDRO) healthcare associated infection(HAI) in patients with malignant tumor, so as to provide basis for making HAI prevention and control measures. MethodsTargeted surveillance method was used to survey MDRO HAI in patients with malignant tumor in a hospital from January 1 to December 31, 2014, WHONET 5. 3 software was used to analyze the data. ResultsA total of 54 056 patients with malignant tumor were surveyed, HAI occurred in 3 542 (6.55%) patients, 847（23.91%）of which were MDRO HAI. Most patients(54.55%) with MDRO HAI were >60 years old. A total of 2 606 bacterial strains were isolated from patients with HAI, 847 (32.50%) of which were MDROs, and most were extended spectrum beta lactamases (ESBLs) producing Escherichia coli (n=459, 54.19%）. The major site of MDRO HAI was lower respiratory tract (47.34%). The top 3 departments of detection of MDROs were departments of thoracic surgery（17.12%）, colorectal and anal surgery（9.92%）, and general surgery (8.26%). ConclusionIncidence of MDRO HAI is higher in patients with malignant tumor, surveillance of high risk population and monitoring of antimicrobial resistance of pathogens should be strengthened, so as to reduce the occurrence of HAI.