2011-2013年儿童专科医院多药耐药菌的感染监测分析  

A monitoring analysis of multidrug-resistant bacteria infection patients in Children Hospital, 2011-2013

作　　者：温婵[1] 耿蓉娜[1] 孙立新[1] 冀迎春[2] 赵博[3] 

机构地区：[1]河北省儿童医院医院感染管理处,河北石家庄050031 [2]河北省儿童医院医院科教处,河北石家庄050031 [3]河北医科大学实验诊断教研室,河北石家庄050031

出　　处：《现代预防医学》2015年第13期2466-2468,2477,共4页Modern Preventive Medicine

基　　金：河北省科技厅立项(132777142)

摘　　要：目的了解多药耐药菌(MDROs)在儿童医院的分布特征及规律,为建立和完善多药耐药菌的监测,有效预防和控制多药耐药菌感染提供依据。方法专职人员每天浏览检验科微生物实验室细菌培养检测结果并登记,监控目标性多药耐药菌,采用回顾性调查方法,对分离到的多药耐药菌的临床分布进行统计分析。结果 2011-2013年我院住院患儿共送细菌培养60 735份,共检出目标性耐药菌株2 071例。2011年和2012年耐药菌检出率为2.4%和1.5%,2013年检出率较前两年明显增高(P<0.05),检出率为5.1%。多药耐药菌感染以革兰阴性菌为主占62%,革兰阳性菌占38%。检出最多的是MRSA,占28.8%。其次是产ESBLs大肠埃希菌占22.7%。2011-2012年以MRSA为主,2013年开展ESBLs监测以来,检出菌株以MRSA和产ESBLs菌株为主。多药耐药菌主要来源于痰标本,占46.8%,其次是血液标本和脓标本,分别占15.7%和13.2%。提示多药耐药菌感染部位主要在呼吸道,血液和器官腔隙。结论通过建立多药耐药菌监控和管理措施,加强对儿童医院多药耐药菌的监测,做到早发现,早隔离,早治疗,可以减少多药耐药菌的医院感染。Objective To study the distribution characteristics of multidrug-resistant bacteria（MDROs） in Children Hospital of Hebei, and provide effective basis for establishing and improving the monitoring of MDROs and the prevention and control to reduce the infection rate. Methods The infection control staff reviewed and registered the results of the detection of MDROs in the microbial laboratory and monitored targeted MDROs every day. The distribution of the specimens from the isolated MDROs were analyzed by the retrospective method. Results A total of 60735 patients of children were sent to bacterial culture between 2011 and2013. 2071 cases of MDROs were detected. The detection rate of 2011 and 2012 were 2.4% and 1.5%, respectively. The detection rate of 2013 was 5.1%, which was higher than 2011 and 2012. Gram-negative bacteria and gram-positive bacteria were accounted for 62% and 38%, respectively. MRSA was the prominent pathogens, which accounted for 28.8%. The second was E.coli of ESBLs,which accounted for 22.7%. Between 2011 and 2012, MRSA detection rate was the highest. Since 2013, the ESBLs was carried out,and the detection of strains were mainly MRSA and E.coli of ESBL. The majority of the MDROs were isolated from the respiratory tract specimens, accounting for 46.8%. Secondly, it was isolated from blood and pus, accounting for 15.7% and 13.2%, respectively.It showed that the respiratory tract, blood and organ cavities were the major types of infections in our children hospital. Conclusion The early detection, isolation, and treatment can be achieved by setting up the monitoring and management measures for the MDROs, and therefore we can reduce the incidence of MDROs infections.

关 键 词：多药耐药菌 儿童 监测 感染 

分 类 号：R179[医药卫生—妇幼卫生保健]