某院多重耐药菌感染分布及抗菌药合理使用分析  

Analysis of Infection Distribution of Multidrug-resistant Organisms and Rational Use of Antibiotics in a Hospital

作　　者：王红娜 冬敏[1] 杨振[1] WANG Hongna;DONG Min;YANG Zhen(Hospital Infection Management Department,the First Afiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州大学第一附属医院医院感染管理科,河南郑州450000

出　　处：《中国药物滥用防治杂志》2023年第3期441-444,共4页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20220809)。

摘　　要：目的:检测某院多重耐药菌(MDRO)感染情况,并分析其抗菌药的用药合理性。方法:选取2020年5月—2022年5月在某院住院的MDRO感染患者196例,对MDRO感染抗菌药物使用情况进行评价与分析。结果:196例患者共检出196株MDRO。外科检出率为66.84%(131/196),内科为21.94%(43/196),临床各科室中胃肠外科MDRO检出率最高(53株,27.05%),其次为肝胆胰外科(43株,21.94%)。MDRO中,革兰阴性菌131株(66.85%),革兰阳性菌65株(33.15%)。革兰阴性菌中,大肠埃希菌检出率最高,为54.61%(107/196),其次为肺炎克雷伯菌9.69%(19/196);革兰阳性菌中,金黄色葡萄球菌为12.24%(24/196)、表皮葡萄球菌为12.24%(24/196)以及溶血葡萄球菌5.10%(10/196)分列前三。196例MDRO患者中,不合理使用抗菌药物患者50例,整体抗菌药物不合理使用率25.51%(50/196)。不合理用药具体情况中,药物选择不当32例(64.00%)、用法用量不当11例(22.00%)、联用药物不当2例(4.00%)、给药途径不当3例(6.00%)、疗程过长2例(4.00%)。结论:某院MDRO感染抗菌药物的不合理使用率较高,应加强抗菌药物合理使用。Objective:To detect the infection of multidrug-resistant organisms(MDRO)in a hospital and analyze the rationality of the use of antibiotics.Methods:A total of 196 patients with MDRO infection who were hospitalized in a hospital from May 2020 to May 2022 were selected to evaluate and analyze the use of antibiotics for MDRO infection.Results:A total of 196 strains of MDRO were detected in 196 patients.The detection rate of MDRO was 66.84%(131/196)in surgical department and 21.94%(43/196)in internal medicine department.The detection rate of MDRO was the highest in gastrointestinal surgery(53 strains,27.05%),followed by hepatobiliary and pancreatic surgery(43 strains,21.94%).Among MDROs,131 strains(66.85%)were gram-negative bacteria and 65 strains(33.15%)were gram-positive bacteria.Among gram-negative bacteria,the detection rate of Escherichia coli was the highest(54.61%,107/196),fllowed by Klebsiella pneumoniae(9.69%,19/196).Gram-positive bacteria,Staphylococcus aureus was 12.24%(24/196),Staphylococcus epidermidis was 12.24%(24/196),and Staphylococcus haemolyticus was 5.10%(10/196).Among the 196 MDRO patients,50 patients were irrationally treated with antibiotics,and the overall irrational use rate of antibiotics was 25.51%(50/196).Among the specific cases of rrational drug use,there were 32 cases(64.00%)of improper drug selection,11 cases(22.00%)of improper usage and dosage,2 cases(4.00%)of improper drug combination,3 cases(6.00%)of improper route of administration,and 2 cases(4.00%)of long course of treatment.Conclusion:The irrational use rate of antibiotics in MDRO infection in a hospital is high,and the rational use of antibiotics should be strengthened.

关 键 词：多重耐药菌 耐药性 细菌分布 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]