神经外科病房多药耐药菌感染流行趋势及控制措施

目的 分析神经外科病房感染病原菌分布及多药耐药菌耐药特征,探讨多药耐药菌感染预防和控制策略.方法 对2010年1月-2010年12月神经外科病房分离出的病原菌及其药敏结果进行分析.结果 2010年神经外科病房医院感染发生率为12.0％,感染病原菌以革兰阴性菌为主,占88.7％;革兰阳性菌占11.3％;耐甲氧西林金黄色葡萄球菌11株,凝固酶阴性葡萄球菌6株,未检出耐万古霉素金黄色葡萄球菌及耐万古霉素肠球菌;肠杆菌科中大肠埃希菌产ESBLs株检出8株、肺炎克雷伯菌检出9株;多药耐药鲍氏不动杆菌18株、铜绿假单胞菌10株,多药耐药菌株分离率呈上升趋势.结论 神经外科病房分离的多药耐药菌出现的频率增加,加强耐药性监测,合理应用抗菌药物,并落实及时有效的消毒隔离措施,避免多药耐药菌在医院的暴发流行.

Prevalence of multidrug-resistant bacteria infections in neurosurgical wards and control measures

OBJECTIVE To analyze the distribution of pathogens causing infections in neurosurgical wards and the characteristics of drug resistance of multidrug-resistant bacteria so as to propose strategies for the prevention and control of multidrug-resistant bacteria infections.METHODS The pathogenic bacteria isolated from neurosurgery ward from Jan 2010 to Dec 2010 and the drug susceptibility results were analyzed.RESULTS The incidence rate of nosocomial infections in neurosurgery ward in 2010 was 12.0%,gram-negative bacteria were predominant pathogens causing infections,accounting for 88.7%;gram-positive bacteria accounted for 11.3%;there were 11 strains of MRSA and 6 strains of MRSCN,there were no strains of vancomycin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci detected;of the Enterobacteriaceae strains isolated,there were 8 strains of ESBLs-producing Escherichia coli and 9 strains of Klebsiella pneumoniae;there were 18 strains of multidrug-resistant Acinetobacter baumannii and 10 strains of multidrug-resistant Pseudomonas aeruginosa,the isolation rate of the multidrug-resistant strains was increased.CONCLUSION Multidrug-resistant bacteria isolated from neurosurgery ward are increasing.It is necessary to strengthen the surveillance of drug resistance,reasonably use antibiotics,as well as implement the timely and effective disinfection and isolation measures so as to prevent the outbreak and prevalence of multidrug-resistant strains in hospital.