ICU多药耐药菌感染监测与干预研究  

Monitoring of multidrug-resistant organism infections and intervention strategies

作　　者：张跃明[1] 胡丽华[1] 金晓东[2] 

机构地区：[1]武警浙江省总队杭州医院ICU,浙江杭州310051 [2]武警浙江省总队杭州医院检验科,浙江杭州310051

出　　处：《中华医院感染学杂志》2016年第2期304-305,356,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生基金资助项目(2012KYB198)

摘　　要：目的对综合重症监护病房(ICU)多药耐药菌(MDROs)感染情况进行分析,并制定相应的干预措施,以减少耐药菌的产生。方法收集2010年4月-2014年2月在医院综合ICU 305例住院患者的送检标本2 168份进行分析,对培养阳性的病原菌筛选出MDROs,并分析其类型及分布构成等。结果 2 168份标本中共分离出病原菌814株,其中MDROs 408株,排名前3位的菌株依次为鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌;MDROs感染部位以呼吸道和血液为主,分别占70.5%和13.0%。结论 MDROs感染多由于医院感染而引起,因此,应加强医院感染管理,制定切实可行的管理制度,提高ICU护理人员洗手依从性,严格控制和监督器械和材料的消毒工作,降低MDROs感染的发生。OBJECTIVE To investigate the prevalence of multidrug-resistant organisms（MDROs）infections in the intensive care unit（ICU）and put forward the targeted intervention measures so as to reduce the drug-resistant strains.METHODS A total of 2 168 submitted specimens were collected from 305 patients who were hospitalized the general ICU from Apr 2010 to Feb 2014,then the MDROs strains were screened out from the pathogens cultured positive,and the species of the strains and the constituent ratios were observed.RESULTS Totally 814 strains of pathogens were isolated from the 2 168 specimens,of which 408 were MDROs;the top 3species were in turn as the following：Acinetobacter baumannii,Pseudomonas aeruginosa,and Klebsiella pneumoniae.Of the patients with MDROs infections,70.5% had respiratory tract infections,and 13.0% had blood infections.CONCLUSIONThe MDROs infections,to great extent,are induced by the nosocomial infections,therefore,it is necessary for the hospital to strengthen the management of nosocomial infections,formulate the feasible management system,improve the hand washing compliance of the ICU nursing staff,and strictly supervise the disinfection of the instruments and materials so as to reduce the incidence of MDROs infections.

关 键 词：综合重症监护病房 多药耐药菌 医院感染 干预对策 

分 类 号：R378[医药卫生—病原生物学]