多药耐药菌感染患者科室分布特点及影响因素分析  

Distribution of patients with multidrug-resistant organisms infections in departments and influencing factors

作　　者：李燕[1] 巩林霞[2] 高岸英[1] 王子珍[1] 逯霞[3] LI Yan;GONG Lin-xia;GAO An-ying;WANG Zi-zhen;LU Xia(Bingzhou Central Hospitals Binzhou,Shandong 251700,China)

机构地区：[1]滨州市中心医院感染管理科,山东滨州251700 [2]滨州市中心医院甲状腺乳腺外科,山东滨州251700 [3]滨州市中心医院康复医学科,山东滨州251700

出　　处：《中华医院感染学杂志》2019年第22期3502-3505,共4页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(Y2006C02)

摘　　要：目的探究不同科室多药耐药菌感染患者鲍氏不动杆菌(MDR-AB)、多药耐药铜绿假单胞菌(MDR-PA)检测分析科室分布特点及影响因素。方法回顾分析滨州市中心医院2013年8月-2016年8月收治的多药耐药菌感染的住院患者96例治疗情况,分析感染患者的科室特点以及患者感染病原菌情况和耐药性。结果96例多药耐药菌感染的住院患者经检查发现共发生144株常见的多重病原菌感染,最多的为金黄色葡萄球菌(40.28%);96例多重病原菌感染住院患者主要集中在综合ICU、皮肤科以及烧伤科,其中多药耐药鲍氏不动杆菌(MDR-AB)及多药耐药铜绿假单胞菌(MDR-PA)在综合ICU检出率最高,耐甲氧西林金黄色葡萄球菌(MRSA)在皮肤科检出率最高,耐碳青霉烯类的肠杆菌科细菌(CRE)在口腔科检出率最高,耐万古霉素肠球菌(VRE)在烧伤科及呼吸内科检出率最高;长时间住院、长期使用抗菌药物、存在侵入性操作是患者感染的最主要影响因素。结论不同科室的多药耐药菌感染住院患者感染病原菌存在差异,因此在对患者进行治疗的过程中,应根据患者具体情况合理的使用抗菌药物进行治疗,避免抗菌药物的滥用造成病原菌耐药性增强,降低了患者治疗效果。OBJECTIVE To investigate the distribution of patients with multidrug-resistant Acinetobacter baumannii(MDRAB)and multidrug-resistant Pseudomonas aeruginosa(MDRPA)infections in departments and analyze the influencing factors.METHODS A total of 96 patients with multidrug-resistant organisms(MDROs)infection who were hospitalized in Binzhou Central Hospital from Aug 2013 to Aug 2016 were enrolled in study,the treatment outcomes of the patients were retrospectively analyzed,and the distribution of the patients with infection,species of pathogens causing the infection and drug resistance rates were observed.RESULTS Of the 96 hospitalized patients with MDROs infection,totally 144 case-times of patients had common multiple pathogens infection,and 40.28%had Staphylococcus aureus infection.The 96 hospitalized patients with MDROs infection mainly distributed in comprehensive ICU,dermatology department and burns department.The isolation rates of MDRAB and MDRPA were the highest in the comprehensive ICU,the isolation rate of methicillin-resistant S.aureus(MRSA)was the highest in the dermatology department,the isolation rate of carbapenem-resistant Enterobacteriaceae(CRE)was the highest in the stomatology department,and the isolation rate of vancomycin-resistance Enterococcus(VRE)was the highest in the burns department and respiratory medicine department.Long length of hospital stay,long-term use of antibiotics and invasive operation were the major influencing factors for the infection.CONCLUSION The hospitalized patients with MDROs infection in different department vary in the species of pathogens causing the infection.It is necessary to reasonably use antibiotics according to the specific condition of the patients during the treatment and avoid the increase of drug resistance due to abuse of antibiotics so as to boost the curative effect.

关 键 词：患者 病原菌 多药耐药菌 分析 

分 类 号：R44[医药卫生—诊断学]