浦东新区医疗机构多重耐药菌的感染特征研究  

Infection characteristics of multidrug resistant Bacteria in medical institutions of Pudong new area

作　　者：王远萍[1,2] 李妮娅 袁瀚寰 徐红梅 阎思瑾[1,2] 朱渭萍 WANG Yuan-ping;LI Ni-ya;YUAN Han-huan;XU Hong-mei;YAN Si-jin;ZHU Wei-ping(Shanghai Pudong new area Center for Disease Control and Prevention,Shanghai 200136;Pudong Institute of Preventive Medicine,Fudan University;The Sixth People's Hospital Affiliated to Shanghai Jiaotong University,China)

机构地区：[1]上海市浦东新区疾病预防控制中心,上海200136 [2]复旦大学浦东预防医学研究院 [3]上海交通大学附属第六人民医院

出　　处：《中国消毒学杂志》2020年第10期733-736,740,共5页Chinese Journal of Disinfection

基　　金：浦东新区卫生系统优秀青年医学人才培养计划(PWRq2016-16)。

摘　　要：目的掌握浦东新区多重耐药菌的流行病学特征和变化趋势,为本区多重耐药菌的科学防控提供基础数据。方法2016年1月-2018年12月每月对浦东新区监测点医疗机构的出院患者进行多重耐药菌主动监测,并比较社区感染和医院感染的多重耐药菌的感染特征。结果医院感染和社区感染的多重耐药菌发现率分别为0.85%和1.48%;共检出多重耐药菌3129株,总体检出率为15.08%,社区感染组平均年龄大于医院感染组,住院天数低于医院感染组,差异均有统计学意义(P<0.001);社区感染的多重耐药菌患者多发生于下呼吸道、泌尿道和皮肤,医院感染的多重耐药菌患者感染部位多发生于泌尿道、下呼吸道和上呼吸道,2组分布有统计学差异(χ^2=222.917,P<0.001)。结论社区与医院感染的多重耐药菌发现率均处在较低的水平,应根据社区与医院感染多重耐药菌病例流行病学特征上的差异开展针对性的预防和干预。Objective To keep abreast of the epidemiological characteristics and changing trends of multidrug resistant bacteria in Pudong new area,so as to provide basic data for the scientific prevention and control of multidrug resistant bacteria in the area.Methods From January 2016 to December 2018,active surveillance of multidrug resistant bacteria was carried out monthly on discharged patients from medical institutions in monitoring points of Pudong new area.The similarities and differences of multidrug resistant bacteria of community infections and nosocomial infections were compared.Results The discovery rates of multidrug resistant bacteria in nosocomial infections and community infections were 0.85%and1.48%,respectively;3129 strains of multidrug resistant bacteria were detected,the overall detection rate was 15.08%,The average age of community infection group was greater than that of nosocomial infection group.The hospitalization days of community infection group were significantly lower than that of nosocomial infection group,and the above differences were statistically significant(P<0.001).Multidrug resistant bacteria in patients with community infections mostly occurred in lower respiratory tract,urinary tract and skin,and nosocomial infections mostly occurred in urinary tract,lower respiratory tract and upper respiratory tract.There was statistical difference between the two groups(χ~2=222.917,P<0.001).Conclusion The discovery rate of multidrug resistant organisms in community and nosocomial infections in our district is at a low level.Targeted prevention and intervention should be carried out according to the differences in the epidemiological characteristics of community and nosocomial infections of multidrug resistant organisms.

关 键 词：多重耐药菌 社区感染 医院感染 

分 类 号：R446.5[医药卫生—诊断学]