多药耐药菌感染临床分布风险评估与干预对策  

Risk assessment of clinical distribution of multidrug-resistant bacteria infections and intervention countermeasures

作　　者：刘玉岭[1,2] 史广鸿 田真[1,2] 张会平[1,2] 丁真[1,2] 宋红岩[1,2] 

机构地区：[1]安徽医科大学附属宿州医院 [2]宿州市立医院感染管理科,安徽宿州234000

出　　处：《中华医院感染学杂志》2014年第21期5267-5268,5303,共3页Chinese Journal of Nosocomiology

基　　金：安徽省卫生厅科研基金资助项目(2010C115);宿州市科技计划基金资助项目(2012-22)

摘　　要：目的了解多药耐药菌种类与临床分布特点,进行风险评估,为采取干预措施提供依据。方法分析2013年1月1日-12月31日临床分离的多药耐药菌;细菌鉴定与药敏试验采用法国生物梅里埃公司VITEK-32全自动细菌鉴定与药敏系统检测细菌耐药性。结果共分离多药耐药菌467株,其中鲍氏不动杆菌134株,占28.69%,其次为大肠埃希菌127株、肺炎克雷伯菌51株、金黄色葡萄球菌44株、铜绿假单胞菌37株,分别占27.20%、10.92%、9.42%、7.92%;标本来源主要为痰液299株、分泌物69株、尿液62株,分别占64.03%、14.78%、13.28%;痰液中多药耐药菌以鲍氏不动杆菌为主,分泌物和尿液中多药耐药菌以均以大肠埃希菌为主;检出科室前3位依次为ICU、神经内科和普通外科。结论多药耐药菌临床分布风险评估确定预防控制重点,加强对高危科室、高危环节和易感人群的干预,减少多药耐药菌感染和传播。OBJECTIVE To understand the clinical characteristics of distribution of multidrug-resistant bacteria and carry out the risk assessment so as to take intervention measures .METHODS The clinical isolates of multidrug-resistant bacteria were collected from Jan 1 ,2013 to Dec 31 ,2013 ,then the bacterial identification was performed by using VITEK-32 automatic identification system of BioM＆#233;rieux ,France ,and the drug susceptibility testing was carried out with the use of drug susceptibility testing system .RESULTS A total of 467 strains of multidrug-resistant bacteria have been isolated ,including 134 （28 .69% ） strains of A cinetobacter baumannii ,127 （27 .20% ） strains of Escherichia coli ,51 （10 .92% ） strains of K lebsiella pneumoniae ,44 （9 .42% ） strains of Staphylococ-cus aureus ,and 37 （7 .92% ） strains of Pseudomonas aeruginosa .Among the isolated multidrug-resistant bacteria , 299 （64 .03% ） strains were isolated from the sputum specimens ,69 （14 .78% ） strains from the secretions specimens ,62 （13 .28% ） strains from the urine specimens .The A .baumannii was the predominant species of multidrug-resistant bacteria that were isolated from the sputum specimens ,the E .coli was dominant among the multidrug-resistant bacteria that were isolated from the secretions or urine specimens . The ICU , neurology department ,and general surgery department ranked the top three departments from which the strains were isolated .CONCLUSION It is necessary to conduct risk assessment of clinical distribution of the multidrug-resistant bacteria to determine the key points of prevention ,strengthen the intervention to the high risk departments and high risk links as well as vulnerable populations so as to reduce the incidence of multidrug-resistant bacteria infections .

关 键 词：多药耐药菌 临床分布 风险评估 干预对策 

分 类 号：R978.1[医药卫生—药品]