多药耐药菌感染情况分析及医院感染监测措施的价值研究

目的：研究院内多药耐药菌（MDROs）感染情况及医院感染监测措施的价值。方法：选取MDROs培养阳性的患者资料进行回顾性分析和前瞻性研究,并采取组合式（Bundle）医院感染监测措施,分析MDROs感染情况及监测措施的价值。结果：1MDROs感染1782例,包括医院感染839例（占47.08%）,社区感染944例（占52.92%）,以耐甲氧西林金黄色葡萄球菌、产超广谱内酰胺酶的大肠埃希菌发生率最高,构成比分别为30.04%和39.09%;2对外科、内科、妇产科、儿科以及其他科室的MDROs万日感染率进行比较,采取监测措施后感染率均低于采取监测措施前,差异有统计学意义（χ2=15.273,χ2=7.532,χ2=11.842,χ2=10.842,χ2=8.834;P〈0.05）;3MDROs医院感染的发生率与采取有效的监测措施呈负相关、与社区感染发生率呈正相关。结论：采取组合式医院感染监测措施有助于控制医院MDROs感染。

Analysis on infections caused by MDROs and effect of hospital infection monitoring measures

Objective： To analyze the condition of infectionscaused by MDROs and effect of hospital infection monitoring measures. Methods： Patients with MDROs positive from July 2009 to December 2012were prospectively studied and given Bundle monitoring measures, patients with MDROs positive from January 2006 to June 2012 were retrospectively studied,the condition of hospital acquired infections caused by MDROs and the value of hospital infection monitoring measures were analyzed. Results：（1）the total cases of MDROs infection were 1782, including 839 cases of hospital infection and 944 cases of community infection, separately accounted for 47.08% and 52.92%; the incidence of ESBLs-ECO and MRSA were highest, separately 30.04% ,39.09% ;（2）after monitoring measures, the incidence of MDROs in surgery department（χ2= 15.273, P=0.001）, internal medicine department（χ2=7.532, P=0.021）, gynaecology（χ2= 11.842, P=0.008） and obstetrics department（χ2=10.842, P=0.010）, paediatrics department（χ2=8.834, P=0.017） were lower than those of before monitoring measures; （3）the incidence of hospital acquired infections caused by MDROs were negatively correlated with effective monitoring measures and positively correlated with omnmnity infection. Conclusion： Bundle monitoring measures can contribute to the control of hospital acquired infections caused by MDROs.