149例死亡患者多重耐药菌感染临床调查.docVIP

149例死亡患者多重耐药菌感染临床调查作者单位：471003 河南科技大学第一附属医院 通讯作者：付艳霞 【摘要】 目的 了解死亡患者合并多重耐药感染的基本情况，探讨死亡原因与感染的关系。方法 收集149例合并MDRO感染病死患者的病历资料，分析患者的基础情况和病原菌的分布。结果 149例MDRO感染死亡患者中，主要是呼吸道感染133例（89.26%），其次是手术部位感染10例（6.71%）；149例患者住院期间，有意识障碍、做过手术、机械通气、气管切开或插管的患者分别占77.18%、38.26%、74.50%、66.44%；其中，多重耐药不动杆菌占41.61%，产超广谱β-内酰胺酶（ESBLs）肠杆菌占29.53%，耐甲氧西林葡萄球菌占16.78%，多重耐药铜绿假单胞菌占12.08%。多重耐药感染是患者死亡的危险因素。结论 严格执行消毒隔离制度和医务人员手卫生制度，强化各种侵入性诊疗操作的细节管理，合理应用抗菌药物是降低感染发生率和病死率的有效措施。 【关键词】 多重耐药菌； 死亡率； 消毒； 调查 Relevant factors for 149 dead patients with multidrug-resistant organism infection FU Yan-xia,LIU Yu-kun,FENG Yue-mei,LIANG Jian-hong.The First Affiliated Hospital of Henan Technology University,Luoyang 471003,China 【Abstract】 Objective Understand patients with death merge multiple drug-resistant infection, discusses the basic cause of death and infection relations.Methods Collect medical records of 149 patients with MDRO infection, analysis of the patient’s basic conditions and the distribution of pathogens.Results 149 dead cases with MDRO infection, mainly is respiratory infection 133 cases （ 89.26%）, the second is the surgical site infection 10 cases （6.71%）; 149 patients during be in hospital, conscious barriers, surgery, mechanical ventilation, and trachea cut or intubation 77.18%,38.26%, 74.50%, 66.44%; Among the multidrug-resistant acinetobacter 41.61%,ESBLs-producing E.coli and K.pneumoniae 29.53%, meticillin-resistant staphylococci 16.78%, multidrug-resistant p. aeruginosa12.08%. Multidrug-resistant organism infection is the risk factors of the patients died.Conclusion Strict execution disinfection segregation and medical personnel hand hygiene system.Strengthen detail management of various invasive medical operation, reasonable application is effective measures for reduce infection antimicrobial incidence and mortality. 【Key words】 Multiple drug-resistant bacteria; Mortality; Disinfection; Survey 由于广谱抗菌药物的大量使用和滥用，以及各种侵袭性操作广泛应用，使得临床上分离的多重耐药菌（MDRO）日趋增多和复杂化，尤其是多重耐药菌（MDRO）感染引起的高病死率，已引起医学界的高