ICU多药耐药鲍曼不动杆菌医院聚集性感染的调查干预分析  

Investigation on hospital cluster infection caused by multidrug-resistant Acinetobacter baumannii and intervention measures

作　　者：花静[1] 李家斌[1,2] 王文阳[1] 王进[1] 汤红芳[1] 石光顺[3] HUA Jing LI Jia-bin WANG Wen-yang WANG Jin TANG Hong-fang SHI Guang-shun(Chaohu Hospital of Anhui Medical University , Chaohu ,Anhui 238000, Chin)

机构地区：[1]安徽医科大学附属巢湖医院感染管理科,安徽巢湖238000 [2]安徽医科大学第一附属医院,安徽合肥230032 [3]安徽医科大学附属巢湖医院检验科,安徽巢湖238000

出　　处：《中华医院感染学杂志》2017年第4期739-742,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金(81172737)

摘　　要：目的探讨多药耐药鲍曼不动杆菌引起医院聚集性感染的原因,建立感染预防控制对策。方法对2016年1月-3月10例多药耐药鲍曼不动杆菌医院感染聚集性病例(DRAB NICC)的临床资料及流行病学调查结果进行分析及标本检测分析和统计学描述。结果 10例患者发生在春节前后,均入住ICU病房;均为下呼吸道感染(其中有8例为VAP);6例患者的年龄>65岁,占60%、危重症患者10例均行气管插管、呼吸机治疗,其中1例气管插管14d后转气管切开;其使用一周以上抗菌药物8例占80%;入住ICU时间(3~27)d,平均(10.5)d。结论 DRAB NICC的发生与年龄、基础疾病、有创操作、抗菌药物使用、入住ICU时间、隔离与消毒、手卫生、病区医院感染监控以及AB的生物学特性等有关。OBJECTIVE To explore the causes of hospital aggregated infection caused by multidrug-resistant Acinetobacter baumannii and put forward the prevention and control measures for the infection.METHODS The clinical data were collected from 10 patients with hospital cluster infection caused by multidrug-resistant A.baumannii who were treated in hospitals from Jan 2016 to Mar 2016,the result of epidemiological investigation was analyzed,the specimens were detected,and statistical description was performed.RESULTS The infection occurred in the 10 patients before and after the spring festival,all of whom were hospitalized in the ICU and had lower respiratory tract infection（including 8cases of VAP）;6patients were aged more than 65 years old,accounting for 60%,all of the10 critically ill patients underwent endotracheal intubation and mechanical ventilation,one of whom received tracheotomy after the endotracheal intubation for 14 days.Totally 8patients were treated with antibiotics for more than one week,accounting for 80%;the length of ICU stay varied from 3to 27 days,with the medial length 10.5days.CONCLUSIONThe incidence of multidrug-resistant A.baumannii is associated with the age,underlying disease,invasive operation,use of antibiotics,length of ICU stay,isolation and disinfection measures,hand hygiene,monitoring of nosocomial infection in ward,and biochemical characters of A.baumannii.

关 键 词：鲍曼不动杆菌 多药耐药 医院感染 聚集性病例 

分 类 号：R181.3[医药卫生—流行病学]