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目的分析神经外科重症监护病房(NSICU)多重耐药菌流行变化特点,分析其感染与定植状况,为有针对性地制定防控策略提供依据。方法对2014年1月-2015年4月每例入住NSICU的患者,每日主动监测其多重耐药菌的情况。结果共159例患者检出多重耐药菌,共检测出多重耐药菌218株,其中医院感染42例次,检出最多的是多重耐药/泛耐药鲍曼不动杆菌。多重耐药菌定植率与感染发现率呈正相关关系,但1月-12月定植率有明显升高趋势,而多重耐药菌感染发现率无明显趋势变化。结论 NSICU多重耐药菌以定植状态为主,其明显的季节性变化使医院感染风险处于不同的水平,需要医院感染防控专(兼)职人员在多重耐药菌定植率较高的季节提高警惕,及时发出风险预警,强化医院感染风险管理。NSICU鲍曼不动杆菌已成为医院感染防控的头号对象,其明显的季节性分布特点值得更多关注,并加强其医院感染防控措施的落实。
Objective To analyze the epidemiological characteristics of multidrug-resistant bacteria in neurosurgical intensive care unit (NSICU), analyze its infection and colonization status, and provide evidence for the targeted prevention and control strategy. Methods From January 2014 to April 2015, each patient admitted to NSICU was monitored on a daily basis to monitor the multi-drug resistant bacteria. Results A total of 159 patients were detected with multi-drug-resistant bacteria. A total of 218 multi-resistant strains were detected, of which 42 were hospital-acquired and Acinetobacter baumannii was the most frequently detected. There was a positive correlation between the colonization rate of multidrug-resistant bacteria and the detection rate of infection, but the rate of colonization increased significantly from January to December, but there was no significant change in the detection rate of multidrug-resistant bacteria. Conclusion The multi-drug resistant strains of NSICU are mainly colonized. The obvious seasonal changes make the risk of nosocomial infection at different levels. It is necessary to increase the season when the multi-drug resistant bacteria colonization rate of NSICU is high Vigilance, timely warning of risks, and strengthen risk management of hospital infection. NSICU Acinetobacter baumannii has become the number one target of nosocomial infection prevention and control, and its obvious seasonal distribution deserves more attention and strengthens the implementation of its prevention and control measures for nosocomial infections.