贵州省234所医院多药耐药菌检出及抗菌药物使用现况调查  

Current status of prevalence of multidrug-resistant organisms and use of antibiotics in 234 hospitals of Guizhou province

作　　者：杨俊林 查筑红 杨昆 林丹 李凌竹 罗光英 王敏 YANG Jun-lin;ZHA Zhu-hong;YANG Kun;LIN Dan;LI Ling-zhu;LUO Guang-ying;WANG Min(The Affiliated Hospital of Guizhou Medical University,550004,China)

机构地区：[1]贵州医科大学附属医院医院感染管理科,贵州省医院感染管理质量控制中心,贵州贵阳550004 [2]贵州省人民医院综合病房,贵州贵阳550002

出　　处：《中华医院感染学杂志》2020年第1期49-53,共5页Chinese Journal of Nosocomiology

基　　金：中国老年医学会感染预防控制研究基金项目(GRYJ-KLB2018028)。

摘　　要：目的了解贵州省二级及以上医疗机构多药耐药菌检出及抗菌药物使用现状,指导各级医院做好医院感染预防控制工作。方法采用填写调查表的方式,对参与监测医院2017年1月1日-12月31日的多药耐药菌检出及抗菌药物临床使用相关数据进行收集,运用SPSS 23.0统计软件进行数据分析。结果本次调查全省234所医疗机构的数据显示,多药耐药菌医院感染率为0.076%、多药耐药菌检出率为14.04%;不同多药耐药菌检出率差异具有统计学意义(χ^2=15478.703,P<0.001),其中耐碳青霉烯类鲍氏不动杆菌(Carbapenem-resistant Acinetobacter baumanni, CRAB)检出率最高(44.14%),耐万古霉素粪肠球菌检出率最低(2.39%);不同多药耐药菌医院感染率差异有统计学意义(χ^2=1399.744,P<0.001),其中CRAB医院感染率最高(0.0279%),耐万古霉素粪肠球菌医院感染率最低(0.00033%);住院患者抗菌药物使用率为50.90%、抗菌药物使用前病原学送检率为33.85%;不同等级医疗机构的上述指标比较,差异均具有统计学意义(P<0.001)。结论调查掌握了贵州省不同地区、不同级别二级以上医疗机构的多药耐药菌检出率及抗菌药物使用率等数据,为院感质控中心指导全省各级医疗机构做好医院感染预防控制工作奠定了基础。OBJECTIVE To understand the current status of prevalence of multidrug-resistant organisms(MDROs) and use of antibiotics in second grade or above hospitals of Guizhou province so as to provide guidance for prevention and control of nosocomial infection. METHODS By means of questionnaire survey, the data of isolated MDROs and use of antibiotics were collected from the surveyed hospitals from Jan 1, 2017 to Dec 31, 2017, and the statistical analysis was performed with the use of SPSS 23.0 software. RESULTS The data of the 234 hospitals surveyed showed that the incidence of MDROs nosocomial infection was 0.076%, the isolation rate of MDROs was 14.04%;there was significant difference in the isolation rate among the MDROs(χ^2=15478.703,P<0.001), the isolation rate of Carbapenem-resistant Acinetobacter baumanni(CRAB) was the highest(44.14%), the isolation rate of Vancomycin-resistant Enterococcus faecalis was the lowest(2.39%).There was significant difference in the incidence of nosocomial infection among the MDROs(χ^2=1399.744,P<0.001),the incidence of CRAB nosocomial infection was the highest(0.0279%), and the incidence of Vancomycin-resistant Enterococcus faecalis nosocomial infection was the lowest(0.00033%).The utilization rate of antibiotics of the hospitalized patients was 50.90%, the etiological submission rate was 33.85% before the antibiotics were used.There were significant differences in the above indexes among the different grades of medical institutions(P<0.001). CONCLUSION The mastery of data of the second grade or above medical institutions of Guizhou provinces such as the isolation rate of MDROs and utilization rate of antibiotics may lay the foundation for prevention and control of nosocomial infection in the medical institutions under the instruction of quality control center.

关 键 词：医院感染 多药耐药菌 抗菌药物 现况调查 

分 类 号：R378[医药卫生—病原生物学]