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目的了解常见多药耐药菌(MDRO)在综合医院的流行特征,为临床提供预防控制依据。方法收集2014年1-12月107 051例患者临床资料,分析MDRO感染率及科室分布,进行统计分析。结果 2014年1-12月监测的6种MDRO及感染病例634例,感染率为0.59%,6种MDRO检出例数及其构成比分别为耐碳青霉烯类抗菌药物的鲍氏不动杆菌(CR-AB)326例(51.42%)、耐碳青霉烯类抗菌药物的铜绿假单胞菌(CR-PA)115例(18.14%)、MRSA 161例(25.39%)、耐碳青霉烯类抗菌药物的大肠埃希菌(CR-E.coli)9例(1.42%)、耐碳青霉烯类抗菌药物的肺炎克雷伯菌(CR-KP)7例(1.10%)、泛耐药肠杆菌科细菌(XDR-ENT)16例(2.52%);CR-AB、CR-PA和MRSA在烧伤整形外科分布最多,其次是ICU和中医科病区;CR-E.coli、CR-KP和XDR-ENT散在分布于少数科室;分离出的MDRO中,医院感染例数占总例数的49.68%,CR-AB、XDR-ENT、CR-PA、CRE.coli、CR-KP和MRSA医院感染病例的构成比分别为57.56%、56.25%、46.96%、44.44%、42.86%和36.65%。结论综合医院MDRO的感染率比较低;CR-AB是最常见的MDRO,其次是MRSA和CR-PA;烧伤整形外科病房、ICU和中医科病房是MDRO管理的重点科室;MDRO社区感染和医院感染的预防控制均应重视。
Objective To understand the prevalence of common multidrug-resistant bacteria (MDRO) in general hospitals and provide the basis for prevention and control in clinical practice. Methods Clinical data of 107 051 patients from January to December in 2014 were collected. The infection rate and department distribution of MDRO were analyzed and statistically analyzed. Results Six MDROs and 634 cases were detected from January to December in 2014, with an infection rate of 0.59%. The number of cases detected by six kinds of MDROs and their constituent ratios were respectively that of Carbapenem-resistant antimicrobials 326 cases (51.42%) of bacilli (CR-AB), 115 cases (18.14%) of carbapenem-resistant carbapenems resistant to carbapenems, 161 MRSA (25.39% 9 cases (1.42%) of CR-E.coli and 7 cases (1.10%) of Klebsiella pneumoniae (CR-KP) resistant to carbapenems antibacterial drugs, CR-AB, CR-PA and MRSA were the most frequently distributed in burns and plastic surgery, followed by ICU and TCM. CR-E.coli, CR-KP and XDR-ENT scattered in a few departments. Among the MDROs isolated, the number of nosocomial infections accounted for 49.68% of the total number of cases. CR-AB, XDR-ENT, CR-PA, CRE.coli, CR-KP And MRSA nosocomial infection cases were 57.56%, 56.25%, 46.96%, 44.44%, 42.86% and 36.65%, respectively. Conclusion The prevalence of MDRO in general hospitals is relatively low. CR-AB is the most common MDRO, followed by MRSA and CR-PA. Burns and plastic surgery wards, ICU and Chinese medicine wards are the key departments under MDRO management. MDRO community infections and nosocomial infections Prevention and control should be taken seriously.