山东省多中心ICU多药耐药菌目标性监测分析  

Targeted surveillance of multidrug-resistant organisms in multicentered ICUs in Shandong province

作　　者：孙吉花[1] 张学美 邢敏[1] 赵爱荣[3] 张洁[1] 纪冰[4] 宋茜[1] 李翠香[5] 

机构地区：[1]滨州医学院附属医院院感办,山东滨州256603 [2]滨州市妇幼保健院手术室,山东滨州256600 [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检验科,山东滨州256603 [5]滨州医学院附属医院护理部,山东滨州256603

出　　处：《中华医院感染学杂志》2016年第11期2465-2467,2616,共4页Chinese Journal of Nosocomiology

基　　金：中国医院协会医院感染预防与控制能力建设基金资助项目(CHA-2012-XSPX-0629-1);山东省医药卫生科技发展计划基金资助项目(2015WS0491);山东省滨州市科技发展计划基金资助项目(2013ZC1802 2013ZC1714 2013ZC1711)

摘　　要：目的了解山东省多中心ICU多药耐药菌(MDROs)感染趋势,为完善多药耐药菌医院感染预防控制措施提供依据。方法对2013年10月-2014年9月山东省5所三级综合医院ICU的4 300例住院患者进行多药耐药菌目标性监测,数据采用SPSS17.0软件进行统计分析。结果 MDROs总检出率为23.43%,以耐碳青霉烯类鲍氏不动杆菌(CRAB)、耐甲氧西林金黄色葡萄球菌(MRSA)居高,分别为54.89%、35.06%,408例次MDROs感染中,医院感染率为4.39‰,社区感染率为41.63‰,在各MDROs中,以CRAB医院感染率和社区感染率最高为2.94‰和26.36‰;干预前后各病原菌中无VRE检出,干预后总体MDROs、CRAB检出率均明显下降,差异有统计学意义(P<0.05),总体MDROs医院感染率、社区感染率均呈下降趋势,但干预前后医院感染率差异无统计学意义,干预后社区感染率明显下降且差异有统计学意义(P<0.05)。结论多药耐药菌感染日趋严重,采取合理的预防控制措施能有效降低MDROs的检出率及感染率。OBJECTIVE To investigate the trend of multidrug-resistant organisms（MDROs）infections in multicentered ICUs in Shandong province so as to provide guidance for prevention and control of the MDROs infections.METHODS The targeted surveillance of MDROs was carried out for 4 300 patients who were hospitalized the ICUs of 5tertiary general hospitals in Shandong province from Oct 2013 to Sep 2014,and the statistical analysis of data was performed with the use of SPSS17.0software.RESULTS The total isolation rate of MDROs was 23.43%;the isolation rates of carbapenem-resistant Acinetobacter baumannii（CRAB）and methicillin-resistant Staphylococcus aureus（MRSA）were 54.89% and 35.06%,respectively.Among the 408case-times of MDROs infections,the incidence of nosocomial infections was 4.39‰,the incidence of community-acquired infections was 41.63‰.Among the MDROs,the incidence of nosocomial infection caused by CRAB was highest（2.94‰）,and the incidence of community-acquired infection caused by CRAB was highest（26.36‰）.The VRE was not detected among the pathogens before and after the intervention;the isolation rates of both MDROs and CRAB were statistically significantly decreased after the intervention（P〈0.05）.The total incidence rates of nosocomial infections and community-acquired infections caused by the MDROs showed downward trends,there was no significant difference in the incidence of nosocomial infections before and after the intervention,the incidence of community-acquired infections was significantly lower after the intervention than before the intervention,and there was significant difference（P〈0.05）.CONCLUSION The MDROs infections are increasingly severe.Application of reasonable prevention measures can effectively reduce the isolation rate of MDROs as well as the infection rate.

关 键 词：多药耐药菌 目标性监测 干预 

分 类 号：R181.3[医药卫生—流行病学]