呼吸内科多重耐药菌目标性监测效果分析-第三军医大学学报.docVIP

呼吸内科多重耐药菌目标性监测效果分析 何健 赖富华 曾荣芳 【摘要】目的 了解呼吸内科检出多重耐药菌株患者的危险因素，消毒隔离措施执行情况，建立有效防控措施，减少多重耐药菌的院内传播。方法 通过检验科微生物室报告和病历资料，对呼吸内科2010年1月~2012年9月124所有住院患者中检出多重耐药菌株者危险因素进行调查，进行隔离措施干预。结果 呼吸内科分离出的多重耐药菌以革兰阴性杆菌为主，占91.61%，其中主要为大肠埃希菌（ESBLs）、鲍曼不动杆菌和肺炎克雷伯菌（ESBLs）。检出革兰阳性球菌12株，均为耐甲氧西林金黄色葡萄球菌，未发现耐万古霉素肠球菌。检出多重耐药菌株的相关危险因素主要为使用糖皮质激素、应用抗菌药物超过3种、年龄＞70岁，住院时间超过30天。经及时采取正确的消毒隔离措施，切断多重耐药菌的传播途径，有效控制了多重耐药菌的院内传播。 【关键词】多重耐药菌株 目标性监测 危险因素 隔离措施 Respiratory medicine multiple drug-resistant bacteria targeted monitoring effect analysis HE Jian，LAI Fu-Hua，ZENG Rong-Fang 1.The Fifth Peoples Hospital of Chongqing ，Chongqing,400062，China；2. Chongqing University of Commerce,Chongqing，400064，China. Abstract Objective To investigate the risk factors of multiple drug-resistant strains ,disinfection and isolation measures implementation on the department of respiratory , for establishment an effective prevention and control measures, reduce the nosocomial transmission of multidrug-resistant bacteria. Methods on department of respiratory in September 2010 January ~2012,124 of all hospitalized patients in the detection of multiple drug-resistant strains related risk factors for investigation by analyze the microorganism room reports and medical records.Results multi-resistant bacteria gram negative bacilli, accounted for 91.61%, which mainly Escherichia coli ( ESBLs ), Bauman Acinetobacter and Klebsiella pneumoniae ( ESBLs ). Detection of 12 gram positive coccus strains, both for methicillin-resistant Staphylococcus aureus, undetected vancomycin-resistant enterococcus. Detection of f the related risk factors of multiple drug-resistant strains include the use of corticosteroids, antibiotics over 3, age 70 years, hospitalized for longer than 30 days. By timely take appropriate disinfection and isolation measures, cut off the route of transmission of multidrug-resistant organisms, effective control of nosocomial transmission of multidrug-resistant bacteria. 【Key words】:Multidrug-resistant bacteria, Target monitori