摘要
目的分析某三甲医院多药耐药菌的分布状况和变化趋势。方法对2017-2019年湘雅医院住院患者检出的菌株进行分析,对其中的多药耐药菌(MDRO)尤其5种主要特殊耐药菌的检出率、科室分布、年度变化等相关数据进行对比。结果2017-2019年医院MDRO总检出率为53.66%,三年的检出率分别为57.45%、52.63%和50.66%,呈下降趋势(P<0.001)。医院主要特殊耐药菌总检出率为19.14%。医院MDRO总检出菌位居前五的科室分别是:重症医学科、中西医结合、神经外科重症医学病区、神经内科重症医学病区、呼吸内科重症医学病区。呼吸内科重症医学病区的主要特殊耐药菌检出率最高(41.87%),最低的科室为新生儿科(3.73%)。医院检出MDRO株数位于前五位的细菌为:鲍氏不动杆菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌。医院MDRO总检出率尤其大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌的MDRO检出率有下降趋势(均P<0.05);2018年和2019年医院主要特殊耐药菌总检出率尤其耐碳青霉烯肺炎克雷伯菌(CRKP)和耐碳青霉烯铜绿假单胞菌(CRPA)的检出率较2017年有下降趋势(P均<0.05)。结论三年检出的MDRO不断下降,但细菌控制形势依然十分严峻,医院需针对重点科室MDRO的分布特点,构建个性化防控方案,有效遏制MDRO的感染与传播。
OBJECTIVE To analyze the distribution and changing trend of multidrug-resistant bacterias in a tertiary first-class hospital.METHODS The strains detected in inpatients in Xiangya hospital from 2017 to 2019 were analyzed,and the multidrug-resistant bacteria(MDRO),especially the detection rates,department distribution,and annual change of five major special drug-resistant bacteria were analyzed.RESULTS From 2017 to 2019,the total detection rate of MRDO was 53.66%,and the three-year detection rates were 57.45%,52.63%,and 50.66%,respectively,showing a downward trend(P<0.001).The total detection rate of major special drug-resistant bacteria in the hospital was 19.14%.The top five departments of total MDRO detection in the hospital were department of critical care unit,Chinese and Western Medicine,ICU of neurosurgery,ICU of neurology,and ICU of department of respiratory medicine,respectively.The highest department of the total detection rate of major special drug resistant bacteria in the hospital was in the ICU ward of respiratory department(41.87%),and the lowest department was in neonatology(3.73%).The top five MDRO strains detected in the hospital were Acinetobacter baumannii,Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,and Staphylococcus aureus,respectively.The overall detection rate of MDRO in the hospital,especially that of E.coli and K.pneumoniae,and P.aeruginosa,showed a downward trend(all P<0.001).In 2018 and 2019,the total detection rates of major special drug-resistant bacterias in the hospital,especially detection rate of CRKP and CRPA,decreased compared with that in 2017(all P<0.05).CONCLUSION Although the detection of MDRO in the past three years showed a downward trend,the control situation of the main specific drug resistance bacteria is still very serious.The hospital needs to build a personalized prevention and control plan based on the distribution characteristics of MDRO in key departments to effectively curb the infection and spread of MDRO.
作者
刘波
吴安华
李春辉
付陈超
左双燕
李洁
黄勋
豆清娅
LIU Bo;WU An-hua;LI Chun-hui;FU Chen-chao;ZUO Shuang-yan;LI Jie(Xiangya Hospital,Central South University,Changsha,Hunan 410008,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第11期1638-1643,共6页
Chinese Journal of Nosocomiology
基金
湖南省自然科学基金资助项目(2021JJ40980)。
关键词
多药耐药菌
耐甲氧西林金黄色葡萄球菌
耐碳青霉烯铜绿假单胞菌
耐碳青霉烯大肠埃希菌
耐碳青霉烯肺炎克雷伯菌
耐碳青霉烯鲍氏不动杆菌
Multidrug resistant bacteria
Methicillin-resistant Staphylococcus aureus
Carbapenem-resistant Pseudomonas aeruginosa
Carbapenem-resistant Escherichia coli
Carbapenem-resistant Klebsiella pneumoniae
Carbapenem-resistant Acinetobacter baumannii
