摘要
目的分析急诊重症监护病房(EICU)多药耐药菌的分布及感染危险因素。方法回顾性调查2016年1月-12月医院88例EICU住院患者的临床资料,比较多药耐药组42例患者和非多药耐药组46例患者的差异,分析多药耐药菌的分布特征,对多药耐药菌感染相关因素进行分析。结果共检出多药耐药致病菌42株,多药耐药菌依次为耐碳青霉烯类抗菌药物鲍氏不动杆菌(CR-AB)32株占76.19%、耐甲氧西林金黄色葡萄球菌(MRSA)5株占11.90%、耐碳青霉烯类抗菌药物肠杆菌科细菌(CRE)3株占7.14%;CR-AB对头孢哌酮/舒巴坦、替加环素的耐药率分别为18.75%、0.00%,MRSA对替加环素的耐药率为0.00%,MDR-PA对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、替加环素耐药率为0.00%;住院时间>14d、抗菌药物使用时间>3d、中心静脉置管、气管插管、留置导尿管或胃管、机械通气时间≥2d均为EICU患者多药耐药菌感染相关的独立危险因素(P<0.05)。结论 EICU患者多药耐药菌感染是多因素共同引起的结果,临床应针对性采取综合有效措施,降低EICU患者多药耐药菌感染,阻断多药耐药菌的传播。
OBJECTIVE To analyze the distribution and risk factors of multidrug-resistant bacteria in emergency intensive care unit（EICU）.METHODS The clinical data of 88 hospitalized patients in EICU from Jan.2016 to Dec.2016 were retrospectively analyzed.The differences between multidrug-resistant group（42 cases）and non multidrug-resistant group（46 cases）were compared,the distribution characteristics of multidrug-resistant bacteria were analyzed,and related factors of multidrug-resistant bacteria infection were analyzed.RESULTS There were42 strains of multidrug-resistant pathogenic bacteria,including 32 strains of carbopenems-resistant Acinetobacter baumanii（CR-AB）accounting for 76.19%,5 strains of methicillin-resistant Staphylococcus aureus（MRSA）accounting for 11.91%,and 3 strains of carbopenems-resistant Enterobacteriaceae（CRE）accounting for 7.14%.The drug resistant rates of CR-AB to cefoperazone/shubatan and tigecycline were 18.75%and 0%,that of MRSA to tigecycline was 0.00%,and those of MDR-PA to cefoperazone/shubatan,piperacillin/tazobactam,imipenem,and tigecycline were all 0.00%.Hospitalization time14 d,antibiotics usage time3 d,central venous catheter,endotracheal intubation,indwelling catheter or tube,and mechanical ventilation time≥2 dwere related independent risk factors for EICU patients with multidrug-resistant bacteria infection（P〈0.05）.CONCLUSION Multidrug-resistant bacteria infection in NICU patients is the result of multiple factors,clinical comprehensive and effective measures should be taken to reduce the multidrug-resistant bacteria infection in NICU patients,and to prevent the spread of multidrug-resistant bacteria.
作者
曾维兰
罗锋
张丽琴
巫莉萍
ZENG Wei-lan LUO Feng ZHANG Li-qin WU Li-Ping(People＇s Hospital of Ganzhou City ,Ganzhou, Jiangzi 341000, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第20期4672-4674,4703,共4页
Chinese Journal of Nosocomiology
关键词
急诊重症监护室
多药耐药菌监测
危险因素
Emergency ICU
Multidrug-resistant bacteria monitoring
Risk factors
