本文選題：重癥監(jiān)護(hù)病房 + 醫(yī)務(wù)人員��； 參考：《中國(guó)感染控制雜志》2016年08期

【摘要】：目的了解重癥監(jiān)護(hù)病房(ICU)醫(yī)務(wù)人員鼻前庭病原菌定植情況,為加強(qiáng)ICU醫(yī)院感染的預(yù)防與控制提供依據(jù)。方法 2015年5月主動(dòng)篩查某院ICU非感染狀態(tài)下的醫(yī)務(wù)人員鼻前庭細(xì)菌定植情況,并進(jìn)行細(xì)菌培養(yǎng)、菌株分離及菌種鑒定。分析調(diào)查結(jié)果并與同期患者檢出細(xì)菌的耐藥情況進(jìn)行比較。結(jié)果共調(diào)查醫(yī)務(wù)人員96名,從鼻前庭標(biāo)本中分離病原菌43株,分別來(lái)自不同的醫(yī)務(wù)人員,病原菌分離率及攜帶率均為44.79%。分離的主要病原菌為金黃色葡萄球菌(15株,占34.88%),其次為產(chǎn)氣腸桿菌(9株,占20.93%)、肺炎克雷伯菌(7株,占16.28%)等。醫(yī)生、經(jīng)常吸煙及從不鍛煉的醫(yī)務(wù)人員鼻前庭病原菌的檢出率較高,差異具有統(tǒng)計(jì)學(xué)意義(均P0.05)。43株病原菌中檢出1株耐亞胺培南的肺炎克雷伯菌。醫(yī)務(wù)人員檢出的7株肺炎克雷伯菌對(duì)氨芐西林/舒巴坦、頭孢唑林、呋喃妥因的耐藥率均50.00%,對(duì)頭孢噻肟與亞胺培南的耐藥率分別為28.57%、14.29%;同期患者檢出的11株肺炎克雷伯菌對(duì)呋喃妥因的耐藥率為100.00%,對(duì)其他常用抗菌藥物均敏感。醫(yī)務(wù)人員檢出的4株大腸埃希菌對(duì)氨芐西林的耐藥率為75.00%,對(duì)慶大霉素、妥布霉素、左氧氟沙星、環(huán)丙沙星及復(fù)方磺胺甲口惡唑的耐藥率均為50.00%,而同期患者檢出的6株大腸埃希菌對(duì)大部分常用抗菌藥物均耐藥。結(jié)論長(zhǎng)期工作在ICU的醫(yī)務(wù)人員鼻前庭病原菌定植率高,定期主動(dòng)對(duì)醫(yī)務(wù)人員鼻前庭病原菌定植情況進(jìn)行篩查及監(jiān)測(cè),對(duì)預(yù)防醫(yī)院感染,防止醫(yī)務(wù)人員與患者之間的交叉?zhèn)鞑ゾ哂兄匾饬x。
[Abstract]:Objective to investigate the pathogen colonization of nasal vestibule of ICU medical staff in intensive care unit (ICU), and to provide evidence for strengthening the prevention and control of nosocomial infection in ICU. Methods in May, 2015, the nasal vestibular bacterial colonization of medical staff in ICU of a hospital was actively screened, and bacteria culture, isolation and identification of bacteria were carried out. The results were analyzed and compared with the drug resistance of bacteria detected in the same period. Results A total of 96 medical workers were investigated and 43 strains of pathogenic bacteria were isolated from nasal vestibule specimens. The isolation rate and carrying rate of pathogenic bacteria were 44.79 and 44.79 respectively. The main pathogenic bacteria isolated were Staphylococcus aureus 15 strains (34.88m), Enterobacter aerogenes 9 strains (20.93%), Klebsiella pneumoniae 7 strains (16.28%) and so on. Doctor, the detection rate of nasal vestibular pathogens in medical workers who often smoked and never exercised was higher, and the difference was statistically significant (all P0.05%. 43 strains of pathogenic bacteria were detected one Klebsiella pneumoniae resistant to imipenem. Seven strains of Klebsiella pneumoniae were detected by medical workers for ampicillin / sulbactam, cefazolin, The resistance rates to cefotaxime and imipenem were 28. 57 and 14. 29, respectively, and the resistance rates of 11 Klebsiella pneumoniae to furantoin were 10. 00g, sensitive to other commonly used antimicrobial agents. The resistance rate of 4 strains of Escherichia coli to ampicillin was 75.00%, and to gentamicin, tobramycin, levofloxacin. The drug resistance rates of ciprofloxacin and compound sulfamethoxazole were 50.00,6 strains of Escherichia coli were resistant to most commonly used antibiotics. Conclusion the pathogen colonization rate of nasal vestibule is high among the medical staff who have been working in ICU for a long time. It is necessary to screen and monitor the pathogen colonization of nasal vestibule regularly and to prevent nosocomial infection. It is of great significance to prevent the cross-transmission between medical staff and patients.
【作者單位】： 第三軍醫(yī)大學(xué)第三附屬醫(yī)院野戰(zhàn)外科研究所;
【分類(lèi)號(hào)】：R446.5;R459.7

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