呼吸科患者多药耐药菌感染的类型及相关因素分析  

Distribution of multidrug-resistant bacteria causing infections in patients of department of respiratory medicine and analysis of related factors

作　　者：吕少敏[1] 王玲玲[1] 俞万钧 

机构地区：[1]浙江省新昌县人民医院内科,浙江新昌县312500 [2]宁波市鄞州人民医院呼吸科,浙江宁波315040

出　　处：《中华医院感染学杂志》2014年第9期2145-2146,2152,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生技术成果计划基金资助项目(2013ZHB008)

摘　　要：目的探讨呼吸科感染多药耐药菌的类型及相关因素,并制定针对性预防措施,以降低感染的发生。方法对呼吸科2011年1月-2013年1月60例多药耐药菌感染患者的临床资料进行回顾性分析,分析其耐药菌株的类型和影响因素,并且制定具体的干预措施;采用WHONET5.3软件进行数据的统计分析。结果共检出118株多药耐药菌,其中革兰阳性菌47株占39.8%,以金黄色葡萄球菌为主,占37.3%,革兰阴性菌71株占60.2%,以鲍氏不动杆菌、肺炎克雷伯菌、大肠埃希菌为主,分别占23.7%、17.8%、12.7%;多药耐药菌感染的相关影响因素有抗菌药物广泛使用、伴有基础性疾病、侵入性操作、免疫下降、未严格执行隔离措施及住院环境较差等。结论呼吸内科感染的多药耐药菌以革兰阴性菌为主,且影响因素较多,临床应加强病原菌的监测,制定具有针对性的干预措施,从而降低感染的发生。OBJECTIVE To explore the distribution of multidrug-resistant bacteria causing infections in department of respiratory medicine and put forward targeted prevention measures so as to reduce the incidence of infections. METHODS The clinical data of 60patients with multidrug-resistant bacteria infections who were treated in the respiratory department from Jan 2011to Jan 2013were retrospectively analyzed,then the species of the drug-resistant bacteria and the influencing factors were analyzed,the specific intervention measures were formulated,and the statistical analysis was performed with the use of WHONET5.3software.RESULTS A total of 118strains of multidrug-resistant bacteria have been isolated,including 47（39.8%）strains of gram-positive bacteria and 71（60.2%）strains of gram-negative bacteria;the Staphylococcus aureus was the predominant species of gram-positive bacteria,accounting for 37.3%;the Acinetobacter baumannii,Klebsiella pneumoniae,and Escherichia coli were dominant among the gram-negative bacteria,accounting for 23.7%,17.8%,and 12.7%,respectively.The influencing factors for the infections caused by the multidrug-resistant bacteria included the broad use of antibiotics,complication of underlying diseases,invasive operation,decreased immunity,without strict implementation of isolation measures,and poor environment for hospital stay.CONCLUSIONThe gram-negative bacteria are the predominant multidrug-resistant bacteria causing the infections in department of respiratory medicine;there are a variety of influencing factors.It is necessary for the hospital to strengthen the surveillance of pathogens and develop targeted intervention measures so as to reduce the incidence of infections.

关 键 词：呼吸内科 医院感染 多药耐药菌 

分 类 号：R978.1[医药卫生—药品]