多药耐药菌医院感染目标性监测与危险因素分析  

Targeted monitoring of multidrug-resistant bacteria infections and analysis of risk factors

作　　者：田春梅[1] 李德保[2] 靳双周[3] 孟明哲[4] 龙子媛[1] 郭晓霞[2] 

机构地区：[1]焦作市人民医院感染控制科,河南焦作454000 [2]焦作市人民医院检验科,河南焦作454000 [3]焦作市人民医院呼吸内科,河南焦作454000 [4]焦作市人民医院ICU,河南焦作454000

出　　处：《中华医院感染学杂志》2012年第12期2498-2500,共3页Chinese Journal of Nosocomiology

基　　金：焦作市科技局资金资助课题:焦科[2011]92-9

摘　　要：目的通过对全院临床科室多药耐药菌(MDROs)感染患者进行目标性监测,探讨MDROs感染的危险因素、干预效果、治疗转归等,为临床有效控制MDROs感染提供依据。方法对2010年1-12月全院MDROs感染病例进行目标性监测,每月针对MDROs标本来源、发生科室、临床控制等进行分析,及时采取控制措施;并对其易感因素、干预效果、治疗转归等进行回顾性分析。结果 MDROs检出时间与病程明显相关(r=0.601,P=0.00),与住院时间、糖尿病、肿瘤高度相关(P<0.01),与手术明显相关(P<0.01);与年龄、性别、营养状况、导管相关操作无明显相关;干预效果:单间安置率达35.00%,隔离标志使用率达76.89%,手卫生依从性达47.29%,无菌操作达95.27%;740例患者中,36.49%治愈、0.95%好转、57.70%未愈、3.65%自动出院、1.89%死亡。结论 MDROs感染与患者基础病、住院时间及手术明显相关,未愈率较高,治疗效果差,临床控制力度还需要进一步加强。OBJECTIVE To evaluate the risk factors,the intervention effect,the treatment outcome of multidrug-resistant organisms（MDROs）through targeted monitoring of MDROs in the clinical departments and provide the basis for clinical effective control of the MDROs infections.METHODS The MDROs specimens sources,occurrence,occurrence departments,and clinical control situation were respectively analyzed,the risk factors,intervention effects,and treatment outcome were analyzed retrospectively from Jan 2010 to Dec 2010 of MDROs cases for targeted monitoring.RESULTS MDROs was detected to be significantly related with course time（r=0.601,P=0.00）,and highly related（P0.001） with the length of time,diabetes,cancers,and a clear correlation surgery（P0.01）;it was not significantly related with age,sex,nutrition,catheter related operation（P0.05）;the intervention effect： the placement rate of the single room was 35.00%,the utilization rate of the isolation signs was 76.89%,hand hygiene compliance reached up to 47.29%,the aseptic operation arrived at 95.27%;of 740 patients,36.49% were cured,0.95% were improved,57.70% were uncured,3.65% left hospital by them selves,and 1.89% died.CONCLUSION MDROs infections are significantly related to the underlying diseases,the length of hospital stay and operation with high uncured rate and poor treatment effect,thus the clinical control should be further strengthened.

关 键 词：多药耐药菌 医院感染 目标性监测 危险因素 干预 

分 类 号：R181.32[医药卫生—流行病学]