摘要
目的研究某肿瘤医院重症监护病房(ICU)患者多重耐药医院感染情况及危险因素。方法通过细菌分离鉴定技术和多因素分析方法,对其ICU住院患者临床资料和病原学标本检测结果进行分析。结果连续4年共调查住院患者11592例,发生医院感染279例,感染率为2.41%。从感染患者送检标本中共分离出病原菌270株(例),其中多重耐药医院感染156例,占病原菌总数的57.78%。临床分离的多重耐药菌种类依次为多重耐药鲍曼不动杆菌、耐甲氧西林金黄色葡萄球菌、耐碳青霉烯类肺炎克雷伯菌、多重耐药铜绿假单胞菌和产超广谱β-奶酰胺酶大肠埃希菌,构成比依次为51.92%、23.08%、17.31%、5.77%和1.92%。多因素分析显示,中心静脉置管及其置管天数、尿管使用天数、抗菌药物使用、呼吸机使用等构成多重耐药菌感染的独立危险因素。结论肿瘤医院ICU患者多重耐药医院感染率较高,针对独立危险因素制定防控措施,应特别加强多重耐药菌监测。
Objective To analyze the situation and risk factors of multidrug resistance nosocomial infection in ICU of a tumor hospital.Methods The clinical data and pathogenic samples of patients in intensive care unit(ICU)of a tertiary tumor hospital were analyzed by bacterial isolation and identification technology and multivariate Logistic regression analysis.Results A total of 11592 inpatients were investigated in this hospital for 4 years,279 of them had nosocomial infection,and the infection rate was 2.41%.A total of 270 strains(cases)of pathogenic bacteria were isolated from the samples of infected patients,among which 156 cases were multiple drug resistant nosocomial infection,accounting for 57.78%of the total number of pathogenic bacteria.The clinical isolates of multidrug resistant bacteria were Acinetobacter baumannii,methicillin-resistant Staphylococcus aureus,carbapenem resistant Klebsiella pneumoniae,multidrug-resistant Pseudomonas aeruginosa and extended spectrumβ-lactamase-producing Escherichia coli,and the composition ratios were 51.92%,23.08%,17.31%,5.77%and 1.92%,respectively.Multivariate Logistic regression analysis showed that central venous catheterization and the days of indwelling catheter,the days of urinary catheter use,the use of antibiotics,ventilator use constituted the independent risk factors of multidrug resistant organisms infection.Conclusion The rate of multidrug resistant nosocomial infection of patients in ICU of tumor hospital is high.The prevention and control measures should be made according to the independent risk factors,and the monitoring of multidrug resistant organisms should be strengthened.
作者
杨立娜
刘晓娟
王秀荣
陈洁
YANG Li-Na;LIU Xiao-Juan;WANG Xiu-rong;CHEN Jie(Tangshan People's Hospital,Tangshan Hebei 063000;North China University of Science and Technology Affiliated Hospital,China)
出处
《中国消毒学杂志》
CAS
2020年第2期117-119,共3页
Chinese Journal of Disinfection
关键词
肿瘤医院
重症监护病房
多重耐药
医院感染
危险因素
tumor hospital
intensive care unit
multidrug resistant
nosocomial infections
risk factors
作者简介
杨立娜(1976-),女,河北唐山人,本科,副主任护师,从事医院感染管理工作。
