产超广谱β-内酰胺酶大肠埃希菌感染干预效果的研究

目的 通过加强医院感染监测及实施控制措施,研究产超广谱β-内酰胺酶( ESBLs)大肠埃希菌医院感染干预效果.方法 对某三级甲等医院产ESBLs大肠埃希菌感染患者进行前瞻性监测及控制,按照统一的调查方法进行调查,研究产ESBLs大肠埃希菌感染特点及干预措施的实施效果.结果 共调查大肠埃希菌感染659例次,361例次检出产ESBLs大肠埃希菌,检出率势54.8％,感染检出率较高的标本是痰或气管分泌物及伤口分泌物；在调查的感染病例中,61.2％属社区感染；采取干预措施前,产ESBLs大肠埃希菌感染检出率一直呈明显上升趋势,从2003年的33.0％上升至2006年的63.0％,2007年采取干预措施后,产ESBLs大肠埃希菌感染检出率由63.0％降至52.2％;院内感染产ESBLs大肠埃希菌感染检出率呈下降趋势,从65.2％降至56.9％.结论 采取干预措施可有效控制产ESBLs大肠埃希菌感染,但社区感染产ESBLs大肠埃希菌检出率高是感染控制难点.

Effect of interventions in extended-spectrum β-lactamase-producing Escherichia coliinfections

OBJECTIVE To strengthen the monitoring of nosocomial infections and implement control measures and to study the effect of the interventions in extended-spectrum β-lactamase(ESBLs)-producing Escherichia coli infections.METHODS The patients with ESBLs-producing E.coli infections from a tertiary hospital were prospectively monitored and controlled,by means of the unified investigation,the characteristics of ESBLs-producing E.coli infections and the effects of the intervention measures were studied.RESULTS Of totally 659 case-times of patients with E.coli infections investigated,ESBLs-producing E.coli were isolated from 361 case-times of patients with the isolation rate of 54.8%,the isolates were mainly isolated from the sputum,tracheal secretions,pus or wound secretions;61.2% of the patients were with community-acquired infections;before taking the interventions,the detection rate of ESBLs-producing E.coli was significantly increased,increasing from 33.0% in 2003 to 63.0% in 2006,and after taking the interventions in 2007,the detection rate decreased from 63.0% to 52.2%;the detection rate of ESBLs-producing E.coli causing hospital-acquired infection kept an downward trend,decreasing from 65.2% to 56.9%.CONCLUSION The interventions can effectively control ESBLs-producing E.coli infections,it may have difficulties in the control of ESBLs-producing E.coli causing community-acquired infections.