ICU患者多药耐药鲍氏不动杆菌感染的相关性分析  

Analysis of risk factors for multidrug-resistant Acinetobacter baumannii infection in patients in ICU

作　　者：杨雅红[1] 丁红生[1] 陈卫芳[1] 

机构地区：[1]嘉兴市中医医院院感科,浙江嘉兴314001

出　　处：《中华医院感染学杂志》2015年第19期4351-4352,4374,共3页Chinese Journal of Nosocomiology

基　　金：嘉兴市科学技术局基金资助项目(2011AY1051-8)

摘　　要：目的了解ICU患者多药耐药鲍氏不动杆菌感染的因素,以降低多耐菌感染的发生率。方法数据采用回顾性统计方法,分析2013年1-12月ICU内多药耐药鲍氏不动杆菌感染的发生率。结果 2013年ICU 298例患者发生多药耐药鲍氏不动杆菌感染49例,感染率为16.44%,在夏、秋两季感染多药耐药鲍氏不动杆菌相对较少,月感染率<16.00%,而在春、冬两季感染多药耐药鲍氏菌的较多,月感染率最高达37.50%;49例多药耐药鲍氏不动杆菌感染患者的主要基础疾病为慢性阻塞性肺疾病急性加重、肺部感染、帕金森病,分别占53.06%、18.37%、12.25%;ICU送检的住院患者各类标本,经培养分离出多药耐药鲍氏不动杆菌49株,标本来源以痰液为主占69.39%;49例多药耐药鲍氏菌感染患者使用呼吸机辅助通气46例,占93.88%,通气方式以口腔气管插管为主。结论 ICU患者呼吸机的使用成为感染的最危险因素,要做好医院感染的预防控制工作,加强消毒隔离与呼吸机内外管路的消毒管理,降低多药耐药鲍氏不动杆菌的感染,从而降低医院感染的发生。OBJECTIVE To understand risk factors for multidrug‐resistant Acinetobacter baumannii infection in ICU patients so as to reduce the infection rate .METHODS The multidrug‐resistant A .baumannii infection rate of pa‐tients hospitalized in ICU from Jan .to Dec .2013 were retrospectively analyzed .RESULTS In 2013 ,49 patients （16 .44% ） were infected by multidrug‐resistant A .baumannii .Patients were found to be less susceptible to multi‐drug‐resistant A .baumannii infection in summer and autumn and the monthly infection rate was less than 16 .00% .However ,spring and winter were seasons that patients were easily infected by them and the monthly in‐fection rate was over 37 .50% .The infected patients got the main underlying disease of acute exacerbation of COPD ,pulmonary infection and Parkinson′s ,accounting for 53 .06% ,18 .37% and 12 .25% respectively .Totally 49 strains of multidrug‐resistant A .baumannii were isolated from ICU samples and the samples were mainly from sputum ,which accounted for 69 .39% .In 49 cases who were infected ,46 cases had used ventilators ,accounting for 93 .88% and they mainly adopted oral trachea cannula to breath .CONCLUSION Using of ventilators is the ma‐jor risk factors for ICU patients .To prevent and control hospital infections ,disinfection and sterilization manage‐ment of internal and external piping of the ventilators need to be strengthened and multidrug‐resistant A .bauman‐nii infection should be reduced .

关 键 词：重症监护病房 多药耐药 鲍氏不动杆菌 感染 分析 

分 类 号：R378[医药卫生—病原生物学]