住院患者多重耐药菌感染的调查及干预措施效果分析  

Analysis of infection and intervention for multi-drug resistant organism in hospitalized patients

作　　者：冉素平[1] 贾莉萍[1] 王洪江 娄晓同[1] RAN Su-Ping;JIA Lin-Ping;WANG Hong-Jiang;LOU Xiao-tong(the 306th Hospital of PLA,Beijing 100101,China)

机构地区：[1]解放军第306医院,北京100101

出　　处：《临床肺科杂志》2018年第12期2215-2218,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的了解该院住院患者多重耐药菌感染的现状及实施干预管理措施后的效果,为临床科室多重耐药菌的防控提供理论指导。方法收集该院2016年1月1日至2017年12月31日期间住院患者的临床资料,收集并分析同期微生物室分离出的多重耐药菌感染情况。数据分析使用SPSS17. 0软件。结果2016年至2017年2年住院患者分别为28784例、25686例,非重复细菌分别分离出5860株和4343株,其中多重耐药菌分别为2815株、1938株,分别占48. 04%、44. 62%。同期发生医院感染分别为657例次、503例次,医院感染例次率分别为2. 28%、1. 96%,其中发生多重耐药菌医院感染分别为70例次、29例次,分别占医院感染总例次的10. 65%、5. 77%;多重耐药菌感染不同科室分布不同,综合ICU最高,2年分别为6. 27%、5. 11%,其次为呼吸内科0. 83%、0. 40%,老年病房0. 69%、0. 30%,在上述三个多重耐药菌感染重点科室采取集束化干预管理措施的基础上,2016年,对其它非重点临床科室也采取集束化干预管理措施,2017年全院医院感染例次率、多重耐药菌感染例次率均有所下降;与2016年比较,除综合ICU、呼吸内科和老年病房外,其他科室下降明显,P <0. 01。结论住院患者多重耐药菌医院感染形势严峻,采取集束化干预管理措施可以有效减少医院感染及多重耐药菌医院感染。Objective To understand the infection status of multidrug-resistant organism （MDRO） in hospitalized patients and the effect of intervention measures so as to provide theoretical direction for prevention and control of MDRO infection. Methods The clinical date and non-duplicate isolates from hospitalized patients were collected from January 1, 2016 to December 31, 2017. Clinical and Laboratory Standards Institute （CLSI） were employed to diagnosis MDRO. All the date were analysis by SPSS19.0 software. Results From 2016 to 2017, there were 28784 cases and 25686 cases hospitalized patients each year. The number of non-replicate bacteria isolated were 5860 strains and 4343 strains, in which MDROs were 2815 strains and 1938 strains, with the percentage of 48.04% and 44.62% respectively. The infection cases were 657 and 503 each year, with the infection rate 2.28% and 1.96%. The number of patients with multiple drug-resistant bacteria were 70 cases and 28 cases, with the proportion of 10.65% and 5.77%. The infection rate of MDRO varied from different clinical departments, and the multidrug-resistant bacterial infection rate in comprehensive ICU was the highest. The percentages of patients in the two years were 6.27% and 5.11 % in ICU, followed by respiratory medicine （0.83%, 0.40%） and cadre ward （0.69%, 0.20%）. In 2016, interventions measures were taken in all departments besides the three key departments mentioned above. The infection rate of hospital and multidrug-resistant bacteria was decreased in 2017. Compared with the year of 2016, the rate of hospital infection and MDRO infection was decreased except ICU, respiratory medicine and cadre ward （ P〈 0.01）. Conclusion Infection with MDRO in hospitalized patients should be paid more attention. Interventions measures could reduce the morbidity of infections with MDRO in hospitalized patients.

关 键 词：多重耐药菌 医院感染 干预措施 

分 类 号：R446.5[医药卫生—诊断学]