ICU多药耐药菌感染的分析  

Multidrug-resistant bacteria infections in ICU

作　　者：王敏丽[1] 梁世芬 王冬国[3] 

机构地区：[1]浙江省玉环县人民医院护理部,浙江玉环县317600 [2]浙江省玉环县人民医院医院感染科,浙江玉环县317600 [3]台州市立医院检验科,浙江台州318000

出　　处：《中华医院感染学杂志》2013年第12期3012-3014,共3页Chinese Journal of Nosocomiology

基　　金：浙江省台州市科技局科研项目(081ky30)

摘　　要：目的研究分析ICU多药耐药菌的耐药性,探讨多药耐药菌感染的影响因素及控制感染的综合干预措施。方法对ICU 2011年1-12月多药耐药菌感染率进行调查,统计前5位多药耐药菌对主要抗菌药物的耐药率,回顾性总结多药耐药菌感染的影响因素及预防控制方法。结果 ICU全年多药耐药菌平均感染率为16.56%,以呼吸道感染率最高,为12.49%,导尿管感染率次之为3.12%,中心静脉导管感染率最低为1.86%;居前5位多药耐药菌分别为铜绿假单胞菌13株、鲍氏不动杆菌11株、产超广谱β-内酰胺酶肺炎克雷伯菌9株、奇异变形菌4株、多药耐药大肠埃希菌6株;通过综合干预措施的实施使ICU的2次多药耐药菌感染流行得到了较好的控制,三、四季度的多药耐药菌感染率也分别由一、二季度的25.65%、17.07%下降至13.95%、9.46%。结论环境格局的合理改造、严格执行手卫生及消毒隔离制度、开展连续的耐药性监测、加强对医护人员的教育培训,对控制ICU多药耐药菌感染暴发具有非常重要意义。OBJECTIVE To analyze the drug resistance of the multidrug-resistant bacteria isolated from ICU and explore the risk factors of the multidrug-resistant bacteria infections so as to put forward the comprehensive inter- ventions to the control of infections. METHODS The incidence of multidrug-resistant bacteria infections in ICU was investigated from Jan to Dec 2011, the drug resistance rates of the top five species of multidrug-resistant bacteria to the main antibiotics were taken for statistics, then the influencing factors of the mukidrug-resistant bacteria infections and the prevention and control measures were retrospectively summarized. RESULTS The average incidence of multidrug--resistant bacteria infections in the ICU was 16. 56% in the while year, the incidence of respiratory tract infections was highest （12. 49%）, followed by the catheter-related infections （3.12 % ）, the central venous catheter related infections the lowest （1.86 % ）. There were 13 strains of multidrug- resistant Pseudomonas aeruginosa, 11 strains of multidrug-resistant Acinetobacter baumannii, 9 strains of extend- ed spectrum % lactamase Klebsiella pneumoniae, 4 strains of Proteus mirabilis, and 6 strains of pandrug-resistant Escherichia coli, which were the top five species of multidrug-resistant bacteria. Through the implementation of the comprehensive interventions, the multidrug-resistant bacteria infections were under great control, and the inci dence rates of the multidrug-resistant bacteria infections decreased from 25.65% and 17.07% in the first and sec- ond season down to 13.95% and 9.46% in the third and fourth season. CONCLUSION It is of great significance to the control of multidrug-resistant bacteria infections in the ICU to reasonably transform the environmental pat- terns, strictly implement the hand hygiene and disinfection and isolation system, develop the continuous monito- ring of drug resistance, and strengthen the training of the medical staff.

关 键 词：多药耐药菌 感染率 耐药率 综合干预措施 

分 类 号：R378[医药卫生—病原生物学]