我院药剂科重症监护病房多重耐药菌主动筛查及定植和感染状况调查分析.docVIP

我院药剂科重症监护病房多重耐药菌主动筛查及定植和感染状况调查分析 　　[摘要] 目的 调查分析我院重症监护病房（ICU）患者多重耐药菌现状，尽早发现多重耐药菌感染、定植患者，提供流行病学数据，制定合理的临床干预措施。 方法 2012年7月～2013年5月借助医院查询系统查看病历，并到ICU询问患者及其家属临床症状，收集患者肛拭子、咽拭子、鼻拭子、大便等标本，用培养基培养标本，筛查多重耐药菌。对多重耐药菌的定植与感染情况、院内感染的危险因素等进行调查分析。 结果 162份标本培养出的171株多重耐药菌中，ESBLs大肠埃希菌占87.13%（149/171），高于其他耐药菌（P0.05）。患者自入住ICU到48 h内，由院外带入的多重耐药菌占74.67%，高于社区与我院（P0.05）。 结论 我院ICU患者多重耐药菌的定植与感染以ESBLs大肠埃希菌为主。对检查出的多重耐药菌应及时告诉感染科负责人员，以便做好病房消毒、患者隔离治疗、切断传播途径、避免感染扩大等工作。 　　[关键词] 重症监护病房；多重耐药菌；定植；感染 　　Investigation and analysis of multidrug resistant and colonization infection status in the intensive care unit in our hospital 　　QUAN Bin1 WANG Qingcheng1 HUANG Dongbiao2 　　1.Department of Pharmacy， Traditional Chinese Medical Hospital in Yuhang District of Hangzhou City， Hangzhou 311106，China；2.The People’s Hospital of Pan’an County in Zhejiang Province， Pan’an 322300，China 　　[Abstract] Objective To analyze the multidrug resistant bacteria in intensive care unit （ICU） in our hospital，to identify the patients with multidrug resistant bacteria infection and colonization as early as possible，and to provide epidemiological data and reasonable clinical intervention measures. Methods From July 2012 to May 2013，checked medical records with the help of inquiry system in our hospital， and we also inquired patients and their families about the clinical symptoms in ICU， collected samples such as anal swab， pharyngeal swab， nasal swab， stool et al， all these samples were cultured and the multidrug resistant bacteria were screened. The status of multidrug resistant bacteria colonization and infection， the risk factors of nosocomial infection were analyzed. Results 171 strains of multidrug resistant bacteria were isolated from 162 samples. The rate of Escherichia coli， ESBLs was 87.13%（149/171）， and it was obviously higher than that of other resistant bacteria（P0.05）. In the first 48 hours of patients entered into ICU， the rate of multidrug resistant bacteria came from other hospital was 74.67%， and it was higher