综合医院6种多药耐药菌流行特征分析  

Epidemiological characteristics of 6 species of muldrug-resistant organisms in general hospitals

作　　者：黄娟[1] 黎燕宁[2] 郭世辉[1] 覃金爱[1] 黄小红[1] 张云 韦巧灵[1] 张影华[1] 李兰兰[1] 胡绮萍[1] 

机构地区：[1]广西医科大学第一附属医院医院感染管理科,广西南宁530021 [2]广西医科大学卫生事业管理教研室,广西南宁530021

出　　处：《中华医院感染学杂志》2016年第22期5096-5099,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81260450);广西壮族自治区卫生厅科研基金资助项目(桂卫自筹Z2013023)

摘　　要：目的了解常见多药耐药菌(MDRO)在综合医院的流行特征,为临床提供预防控制依据。方法收集2014年1-12月107 051例患者临床资料,分析MDRO感染率及科室分布,进行统计分析。结果 2014年1-12月监测的6种MDRO及感染病例634例,感染率为0.59%,6种MDRO检出例数及其构成比分别为耐碳青霉烯类抗菌药物的鲍氏不动杆菌(CR-AB)326例(51.42%)、耐碳青霉烯类抗菌药物的铜绿假单胞菌(CR-PA)115例(18.14%)、MRSA 161例(25.39%)、耐碳青霉烯类抗菌药物的大肠埃希菌(CR-E.coli)9例(1.42%)、耐碳青霉烯类抗菌药物的肺炎克雷伯菌(CR-KP)7例(1.10%)、泛耐药肠杆菌科细菌(XDR-ENT)16例(2.52%);CR-AB、CR-PA和MRSA在烧伤整形外科分布最多,其次是ICU和中医科病区;CR-E.coli、CR-KP和XDR-ENT散在分布于少数科室;分离出的MDRO中,医院感染例数占总例数的49.68%,CR-AB、XDR-ENT、CR-PA、CRE.coli、CR-KP和MRSA医院感染病例的构成比分别为57.56%、56.25%、46.96%、44.44%、42.86%和36.65%。结论综合医院MDRO的感染率比较低;CR-AB是最常见的MDRO,其次是MRSA和CR-PA;烧伤整形外科病房、ICU和中医科病房是MDRO管理的重点科室;MDRO社区感染和医院感染的预防控制均应重视。OBJECTIVE To understand the epidemiological characteristics of multidrug‐resistant organisms （MDROs） so as to provide guidance for clinical prevention and control .METHODS The clinical data were collected from 107 051 patients who were treated in hospitals from Jan 2014 to Dec 2014 .The incidence of MDROs infection and distribution of departments were statistically analyzed .RESULTS A total of 6 species of MDROs were moni‐tored from Jan 2014 to Dec 2014 ,and 634 patients had MDROs infections ,with the infection rate 0 .59% .Among the 6 species of MDROs ,the carbapenem‐resistant Acinetobacter baumannii was detected in 326 （51 .42% ） cases , the carbapenem‐resistant Pseudomonas aeruginosa was detected in 115 （18 .14% ） cases ,MRSA was detected in 161 （25 .39% ） cases ,carbapenem‐resistant Escherichiacoli was detected in 9 （1 .42% ） cases ,carbapenem‐resist‐ant K lebsiella pneumoniae was detected in 7 （1 .10% ） cases ,and the pandrug‐resistant Enterobacteriaceae was detected in 16 （2 .52% ） cases .The burn plastic surgery department was the predominant department where the carbapenem‐resistant A .baumannii ,carbapenem‐resistant P .aeruginosa ,and MRSA distributed ,followed by the ICU and traditional medicine department wards .The carbapenem‐resistant E .coli ,carbapenem‐resistant K .pneu‐moniae ,and pandrug‐resistant Enterobacteriaceae scattered in a few of department .Of the cases of nosocomial in‐fections ,49 .68% had the MDROs infection ,57 .56% had carbapenem‐resistant A .baumannii infection ,56 .25%had pandrug‐resistant Enterobacteriaceae infection ,46 .96% had pandrug‐resistant P .aeruginosa infection ,44 . 44% had pandrug‐resistant E .coli infection ,42 .86% had pandrug‐resistant K .pneumoniae infection ,and 36 .65%had MRSA infection .CONCLUSION The incidence of MDROs infection is relatively low in the general hospitals ,the car‐bapenem‐resistant A .baumannii is the most common species of MDROs ,followed by the MRSA and carbapenem‐resis

关 键 词：多药耐药 多药耐药菌 流行病学 医院感染 

分 类 号：R378[医药卫生—病原生物学]