常州市医院感染患者多药耐药菌感染现状与危险因素  

Current status and risk factors for multidrug-resistant bacteria infections in Changzhou

作　　者：杨乐[1] 赵丽霞[1] 喻荣彬[2] 

机构地区：[1]常州市第二人民医院感染管理科,江苏常州213003 [2]南京医科大学公共卫生学院流行病与卫生统计学系,江苏南京210029

出　　处：《中华医院感染学杂志》2012年第21期4897-4899,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解常州市市属二级以上医院感染患者多药耐药菌感染现状与危险因素。方法将市属二级以上医院医院感染横断面调查中确诊的多药耐药菌感染病例作为病例组,非多药耐药菌感染病例作为对照组,对两组进行病例对照研究。结果医院多药耐药菌感染47例,占医院感染病例的13.0%;分离到多药耐药菌50株,耐甲氧西林金黄色葡萄球菌12株占24.0%,耐碳青霉烯类抗菌药物鲍氏不动杆菌6株占12.0%,耐碳青霉烯类抗菌药物铜绿假单胞菌13株占26.0%,耐万古霉素肠球菌1株占2.0%,产超广谱β-内酰胺酶大肠埃希菌12株占24.0%,产超广谱β-内酰胺酶肺炎克雷伯菌6株占12.0%;医院感染部位主要集中在下呼吸道,占56.0%;单因素分析科室、呼吸衰竭、是否手术、是否有血管通路、是否使用抗菌药物,差异均有统计学意义;多因素logistic回归分析使用抗菌药物是医院感染多药耐药菌的危险因素,手术是医院感染多药耐药菌的保护因素。结论常州市市属二级以上医院需建立并完善医院感染多药耐药菌监测系统,积极控制院内下呼吸道感染,加强抗菌药物管理,采取综合措施来预防和控制医院多药耐药菌感染。OBJECTIVE To investigate the prevalence and risk factors of multidrug-resistant organism（MDRO） infections in the patients of two A or two A above hospitals in Changzhou.METHODS The patients,who were diagnosed as the MDRO infections through the cross-sectional investigation,were selected as the study group,and the patients who were negatively diagnosed as the MDRO infections were set as the control group,then the case-control study was performed.RESULTS There were 47（13.0%） patients with MDRO infections.Totally 50 strains of MDROs were isolated,including 12（24.0%） strains of methicillin-resistance Staphylococcus aureus,6（12.0%） strains of carbapenems-resistant Acinetobacter baumannii,13（26.0%） strains of carbapenems-resistant Pseudomonas aeruginosa,1（2.0%） strain of vancomycin-resistant Enterococci,12（24.0%） strains of extended spectrum β-lactamases producing Escherichia coli,and 6（12.0%） strains of extended spectrum β-lactamasesproducing Klebsiella pneumoniae.The most site of MDROs infections was lower respiratory tract.The result of the univatiate analysis indicated that the differences in the departments,respiratory failure,operation,vascular access,and use of antibiotics between the two groups were statistically significant.The multivariate logistic regression analysis showed that the use of antibiotics was the risk factor of MDROs infections,while the operation was the protective factor for MDRO infections.CONCLUSION The two A and two A above hospitals should establish and make the monitoring system for MDROs infections sound,actively control the lower respiratory tract infections,strengthen the management of antibiotics,and take comprehensive measures so as to prevent and control the MDROs infections.

关 键 词：医院感染 横断面调查 危险因素 抗菌药物 多药耐药菌 

分 类 号：R378[医药卫生—病原生物学]