医院多重耐药菌感染现状分析及预防措施  

Analysis and precaution measures on present situation of multidrug resistant bacterial infection in hospital

作　　者：殷红莲[1] 汤国宁[1] 韦启飞[1] 郭丽红[1] 

机构地区：[1]云南省玉溪市中医医院检验科,653100

出　　处：《检验医学与临床》2012年第19期2422-2423,2425,共3页Laboratory Medicine and Clinic

摘　　要：目的分析医院多重耐药(MDR)菌感染的现状,加强感染的防治。方法回顾性分析2008～2011年912例住院患者MDR菌感染的病历资料。结果 MDR菌在痰液标本中分离率最高,检出率为24.3%;其次为尿液标本,检出率为22.2%;分泌物检出率19.3%;脓液标本检出率8.7%。MDR菌的年份分布:2008年96株(10.5%);2009年183株(20.1%);2010年294株(32.2%);2011年339株(37.2%)。MDR菌在临床科室的构成比:呼吸内科13.5%;泌尿外科11.8%;妇产科11.4%;消化内科10.9%;肛肠科9.4%;心内科7.7%;普通外科6.7%;急诊科6.5%;骨伤科6.0%。该院MDR菌株以产ESBLs的大肠埃希菌为主,检出486株,占总数的53.3%;其次为产ESBLs的肺炎克雷伯菌78株,占8.6%;粪肠球菌59株,占6.5%;其他菌株289株,占31.7%。结论该院MDR菌的感染以产ESBLs的大肠埃希菌居多,患者MDR菌的感染部位以呼吸道为主,感染科室以呼吸内科为主,MDR菌的感染呈逐年上升的趋势。合理应用抗菌药物是控制MDR菌感染产生的关键,MDR菌的感染已日趋严重,应加强监测、预防与控制。Objective To analyze the present situation of multidrug resistant（MDR） bacterial infection for strengthening prevention and treatment of infections.Methods The medical records in 912 cases of MDR bacterial infection from 2008 to 2011 were performed the retrospective analysis.Results The separation rate of MDR bacteria in the sputum specimens was highest,with the detection rate of 24.3%,followed by the urine specimens,with the detection rate of 22.2%.The detection rates were 19.3% in the excretions and 8.7% in the pus specimens.The year distributions of MDR bacteria were as follows：96 strains in 2008（10.5%）,183 strains in 2009（20.1%）,294 strains in 2010（32.2%） and 339 strains in 2011（37.2%）.The constituent ratios of MDR bacteria in the clinical departments were the respiratory department 13.5%,the urinary surgery department 11.8%,the obstetrics and gynecology department 11.4%,the digestive system department 10.9%,the anorectal department 9.4%,the cardiological department 7.7%,the general surgery department 6.7%,the emergency department 6.5% and the department of orthopedics and traumatology 6.0%.MDR bacteria in our hospital were mainly ESBLs-producing Escherichia coli,486 strains,accounting for 53.3%.The second was ESBLs-producing Klebsiella pneumoniae,78 strains（8.6%）,Enterococcus faecalis,59 strains（6.5%）.Other types of bacteria were 289 strains,accounting for 31.7%.Conclusion The MDR bacterial infection in our hospital is dominated by ESBLs-producing Escherichia coli.The respiratory tract is the main infection position and the infection department is mainly the respiratory department.MDR bacterial infection shows the increasing trend year by year.Rational antibacterial use is the key to control MDR bacterial infections.MDR bacterial infection is increasingly serious.The monitor,prevent and control of MDR bacterial infection should be strengthened.

关 键 词：多重耐药 细菌感染 痰液 

分 类 号：R53[医药卫生—内科学]