本文選題：多藥耐藥菌　切入點：醫(yī)院感染　出處：《中華醫(yī)院感染學雜志》2017年18期

【摘要】：目的了解住院患者五大類多藥耐藥菌醫(yī)院感染的現(xiàn)狀、特點、分布規(guī)律及預后,為科學制定預防控制措施提供依據(jù)。方法通過醫(yī)院感染實時監(jiān)控系統(tǒng),對某院2014年1月-2015年12月住院期間發(fā)生的耐碳青霉烯類鮑氏不動桿菌(CRAB)、耐碳青霉烯類銅綠假單胞菌(CRPA)、耐碳青霉烯類腸桿菌科細菌(CRE)、耐甲氧西林金黃色葡萄球菌(MRSA)、耐萬古霉素腸球菌(VRE)等五大類多藥耐藥菌(MDRO)感染的患者進行目標性監(jiān)測,醫(yī)院感染專職人員對每份感染病歷進行逐項查閱,并及時填寫《多藥耐藥菌個案登記表》。結(jié)果監(jiān)測期間,全院多藥耐藥菌檢出率為61.18%,其中五大類多藥耐藥菌檢出率為23.55%,導致發(fā)生醫(yī)院感染677人次,770例次,五大類多藥耐藥菌醫(yī)院感染日感染人次率0.29‰,日例次感染率0.34‰,五大類多藥耐藥菌醫(yī)院感染人次感染率0.30%,例次感染率0.34%;感染患者平均(47.47±21.43)歲,平均住院天數(shù)(36.54±28.55)d;770株多藥耐藥菌構(gòu)成中,CRAB 423株,占54.94%,CRPA 94株,占12.21%,CRE 180株,占23.38%,MRSA 71株,占9.22%,VRE 2株,占0.26%;標本來源以痰為主,其次是血標本和分泌物;感染部位中以下呼吸道居多,占45.08%,其次是手術(shù)部位感染和血流感染。五大類多藥耐藥菌醫(yī)院感染日例次感染率排名前五位的科室分別為神經(jīng)外科ICU(7.43‰)、中心ICU(7.11‰)、呼吸ICU(3.97‰)、神經(jīng)內(nèi)科ICU(3.91‰)、燒傷外科(1.52‰)。結(jié)論某院多藥耐藥菌檢出形勢嚴峻,五大類多藥耐藥菌醫(yī)院感染導致患者住院時間延長、預后欠佳,因此應(yīng)及時準確做好病原菌監(jiān)測,提高標本送檢質(zhì)量,多學科協(xié)作強化多藥耐藥菌感染預防控制工作,進而保障患者安全。
[Abstract]:Objective to investigate the status, characteristics, distribution and prognosis of five major types of multidrug resistant bacteria (MDR) nosocomial infection in hospitalized patients, and to provide scientific basis for the establishment of preventive and control measures. Methods the real-time monitoring system for nosocomial infection was used. In a hospital from January 2014 to December 2015, Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus and Staphylococcus aureus, which were hospitalized from January 2014 to December 2015, were tested. Patients infected with vancomycin resistant Enterococcus enterococci (VREE) and other five major multidrug resistant bacteria (MDROs) were monitored on a targeted basis. The nosocomial infection staff consulted each case history item by item, and filled out the multidrug resistance case registration form in time. The detection rate of multidrug resistant bacteria in the whole hospital was 61.18, among which the detection rate of five major multidrug resistant bacteria was 23.55, which resulted in 677 hospital infections, and the nosocomial infection rate of five major multidrug resistant bacteria was 0.29 鈥，

本文編號：1670071