【摘要】 目的探讨重症监护病房(ICU)多药耐药菌(MDROs)流行现状及其感染特征,指导临床对MDROs的预防与控制工作。方法在MDROs目标性监测的基础上,对ICU 2011年MDROs的分布、来源及感染特征进行统计学分析。结果 ICU收治患者539例,发生MDROs感染68例、97例次,感染率12.69%、例次感染率18.28%;送检标本分离出MDROs102株:革兰阴性菌84株占82.35%,革兰阳性菌18株占17.65%;主要是泛耐药与多耐药鲍氏不动杆菌占50.98%,其中泛耐药鲍氏不动杆菌占96.15%;其他依次是产ESBLs大肠埃希菌、泛耐药与多药耐药铜绿假单胞菌、耐甲氧西林金黄色葡萄球菌、耐甲氧西林凝固酶阴性葡萄球菌、产ESBLs肺炎克雷伯菌、耐碳青霉烯类肠杆菌科细菌,分别占13.73%、10.78%、8.82%、8.82%、5.88%和0.98%;MDROs的来源本科获得占63.73%;感染部位以下呼吸道为主,占66.67%;MDROs感染与有创诊疗操作相关占60.78%。结论ICU患者MDROs感染率较高,以革兰阴性菌为主,感染以呼吸道为主,有创诊疗操作是引起MDROs感染的重要因素。更多还原

【Abstract】 OBJECTIVE To investigate the epidemic situation and their infection characteristics of multi-drug resistant organisms(MDROs) in intensive care unit(ICU) so as to guide clinical prevention and control of MDROs.METHODS Based on the target surveillance,the composition,origin and their infection characteristics of MDROs were analyzed statistically in certain ICU in 2011.RESULTS A total of 539 patients discharged from ICU,among which 68 patients infected with MDROs accounted for 12.69% and 97 case-times of patients infected accounted for 18.28%.A total of 102 strains of MDROs were isolated from the submitted specimens,including 84(82.35%) strains of gram-negative bacteria and 18(17.65%) strains of gram-positive bacteria,the most common bacteria were pan-resistant and multi-resistant Acinetobacter baumannii(PDR/MDRAB) which accounted for 50.98%,followed by the ESBLs-producing Escherichia coli(13.73%),pan-resistant and multi-resistant Pseudomonas aeruginosa(10.78%,methicillin-resistant Staphylococcus aureus(8.82%) and methicillin-resistant coagulase-negative Staphylococci(8.82%),ESBLs-producing Klebsiella pneumoniae(5.88%),and carbapenems-resistant Enterobacteriaceae(0.98%).Of 102 strains of MDROs isolated,63.73% were from the clinical departments.The lower respiratory tract was the infection site,accounting for 66.67%.There were 60.78% of the patients with MDROs infections which was associated with the invasive treatment and diagnosis operation.CONCLUSION The incidence of MDROs infections is high in the patients in ICU,the gram-negative bacteria are the main pathogens causing the respiratory tract infections.The invasive diagnosis and treatment operation are the main causes of the MDROs infections.更多还原