医院感染多重耐药菌调查分析.docVIP

医院感染多重耐药菌调查分析 　　摘要：目的 调查分析我院感染多重耐药菌的现状，为临床制定针对性防治策略以及临床医师合理用药提供科学依据。方法 对我院自2012年6月～2013年10月临床各科室送检的131例多重耐药菌感染情况进行了回顾性调查分析，观察医院感染多重耐药菌种及其构成比、感染部位和病区分布。结果 调查的131例多重耐药菌感染中，分离出的病原菌主要为肺炎克雷伯菌肺炎亚种和鲍曼不动杆菌，分别占总检出率的57.3%和33.6%；感染标本主要为痰液和肺泡灌洗液，分别占总检出率的55.7%和25.2%；全院检出多重耐药菌最多的科室为重症医学科区，占总检出率的49.6%，其次为神经外科，占17.6%。结论 医院应规范合理应用抗菌药物，避免细菌多重耐药性的产生；关注呼吸道、肺部等易感部位，加强对医院重症医学科区等感染高发病区的监控管理。 　　关键词：医院感染；多重耐药菌；肺炎克雷伯菌肺炎亚种；重症医学科区 　　Abstract：Objective To investigate the current situation of multidrug-resistant organism infections in our hospital， and provide scientific basis for the formulation of preventive strategies and clinical rational drug use. Methods 131 samples of multidrug-resistant organism hospital infections in various clinical departments from 2012 June to 2013 October were analyzed. The bacterial species and their constituent ratio， the infection sites and infected departments distribution were investigated. Results In this investigation， the most isolated pathogenic bacteria were Klebsiella pneumoniae subsp pneumonia and Acinetobacter baumannii accounting for 57.3% and 33.6% respectively； the main infection samples were sputum and bronchoalveolar lavage fluid accounting for 55.7% and 25.2% respectively； intensive care unit was most seriously infected department and it accounted for 49.6%， followed by neurosurgery department which accounted for 17.6% of all infected departments. Conclusion The hospital should standardize the rational use of antimicrobial drugs and avoid the emerge of multidrug-resistant organism， pay attention to susceptible sites such as respiratory tract and lung， and strengthen the monitoring and management of highly infected department in hospital such as intensive care unit area. 　　Key words：Hospital infection； Multidrug-resistant organism； Klebsiella pneumoniae subsp pneumonia； Intensive care unit area 　　多重耐药菌[1]（MDRO）主要是指对临床使用的3类或3类以上抗菌药物同时呈现耐药的细菌。近年来，随着广谱抗菌药物在临床的广泛应用，在治疗感染性疾病的同时，也导致了医院多重耐药菌感染现象的发生率显著升高，给医院感染防控和患者治疗都带来极大挑战。作者对本院自2012年6月～2013年10月临床各科室送检的1