2011-2014年ICU多药耐药菌流行病学分析研究  

Epidemiological analysis of multidrug-resistant organisms isolated from ICU in 2011-2014

作　　者：李翠香[1] 杨燕[1] 邢敏[2] 姜雪锦[2] 赵爱荣[3] 邱会芬[2] 纪冰[4] 孙吉花[2] 

机构地区：[1]滨州医学院附属医院护理部,山东滨州256603 [2]滨州医学院附属医院医院感染管理办公室,山东滨州256603 [3]滨州医学院附属医院药学部,山东滨州256603 [4]滨州医学院附属医院微生物室,山东滨州256603

出　　处：《中华医院感染学杂志》2016年第2期295-297,共3页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展基金资助项目(2011HW056);山东省滨州市科技发展计划基金资助项目(2013ZC1802;2013ZC1714;2013ZC1711);中华医院感染控制研究基金资助项目(ZHYY2014-0027)

摘　　要：目的了解ICU多药耐药菌(MDROs)分布特点及流行趋势,为指导MDROs预防控制措施提供依据。方法前瞻性监测某三级医院2011-2014年ICU住院患者1 231株病原菌构成比、MDROs检出率及标本分布等流行特征;采用SPSS17.0软件对数据进行统计分析。结果 2011-2014年ICU革兰阴性菌构成比均>78.0%,其中2013年高达91.79%,以鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌为主,革兰阳性菌以金黄色葡萄球菌为主;MDROs总检出率4年差异有统计学意义(χ2=21.638,P<0.05),2013年检出率最高,为56.72%,2011年最低,为41.44%,标本来源以痰液为主。结论 ICU医院感染多见于下呼吸道,以革兰阴性菌为主,通过实施目标性监测,加强MDROs预防及控制措施落实,MDROs感染控制有下降趋势,但仍是预防控制重点科室。OBJECTIVE To understand the characteristics of distribution of multidrug-resistant organisms（MDROs）isolated from ICU and observe the trend of prevalence so as to provide guidance for prevention and control of MDROs.METHODS A prospective surveillance was conducted to investigate the constituent ratios of 1 231 strains of pathogens isolated from the patients who were hospitalized the ICU from 2011 to 2014,the isolation rates of MDROs,and distribution of specimens.The statistical analysis of data was performed with the use of SPSS17.0software.RESULTS The constituent ratio of the gram-negative bacteria isolated from the ICU was more than 78.0%in 2011-2014,reaching up to 91.79%in 2013;the Acinetobacter baumannii,Pseudomonas aeruginosa,and Klebsiella pneumoniae were dominant among the gram-negative bacteria.The Staphylococcus aureus was the predominant species of gram-positive bacteria.There was significant difference in the total isolation rate of MDROs among the four years（χ2=21.638,P〈0.05）,the isolation rate was the highest（56.72%）in 2013 and was the lowest（41.44%）in 2011.The sputum was the major specimens source.CONCLUSIONThe lower respiratory tract is the most common nosocomial infection site in the ICU,and the gram-negative bacteria are dominant.It is necessary to conduct the targeted surveillance and strengthen the implementation of prevention measures of MDROs.The incidence of MDROs infections shows a downward trend,and the ICU remains the key department to be focused on.

关 键 词：重症监护病房 医院感染 多药耐药菌 

分 类 号：R378[医药卫生—病原生物学]