摘要
目的探讨某三级综合医院多重耐药菌(MDROs)相关感染对住院费用、抗菌药费用及住院日的影响,评估其导致的经济负担,为多重耐药菌的管理和控制提供指导。方法调查2015年本院细菌株分布情况,分为多重耐药菌组和非多重耐药菌组,对不同菌株的住院费用、抗菌药费用和住院日进行比较分析。结果耐碳青霉烯鲍曼不动杆菌(CRAB)检出率为54.08%(53/98),产ESBLs奇异变形杆菌、大肠埃希菌和肺炎克雷伯菌检出率分别为38.76%(38/98)、33.31%(969/2 906)和26.01%(186/715),多重耐药的阴沟肠杆菌检出率为36.15%(94/261)。MDROs相关感染的平均住医院日较非MDROs的显著增加(t=7.50,P<0.001)。多重耐药的铜绿假单胞菌、阴沟肠杆菌、凝固酶阴性葡萄球菌组患者平均住院日分别为64 d、29 d和26 d,较非耐药组患者(均为18 d)均显著增加,差异具有统计学意义(t=9.03、P<0.001,t=3.39、P=0.001,t=3.09、P=0.002)。多重耐药的铜绿假单胞菌、阴沟肠杆菌、凝固酶阴性葡萄球菌组患者的住院费用/抗菌药费用分别为86 063/5 506元、48 500/2 402元、56 221/2 254元,较非耐药组的23 958/2 024元、23 741/1 590元、20024/1 318元,均显著增多(P均<0.05)。结论 MDROs感染可显著增加患者的住院日及经济损失。积极采取有效的院感管控,提高抗菌药应用水平,以减少患者经济负担。
Objective To investigate the effect multidrug-resistant arganisms （MDROs） related infections on the total hospitalization expense, antibacterial drug costs and the average hospital stay, and to evaluate the economic burden induced multidrug-resistant bacteria and manage and control multiple drug-resistant bacteria in a tertiary general hospital. Methods In 2015, a retrospective survey was conducted to collecte the related data of the patients with MDROs and non-MDROs, and the average hospital stay, the total hospitalization expense, antibacterial drug costs were statistically analyzed, respectively. Results The detection rate of carbapenem-resistant Acinetobacter baumannii （CRAB） related infections was 54.08%, and the rates of ESBLs-producing proteus mirabilis, Escherichia coli and Klebsiella pneumoniae were respectively 38.76%, 33.31% and 26.01%, and the rate of multidrug-resistant Enterobacter cloacae was 36.15%. The average hospital stay of patients with multidrug-resistant bacteria were 64 days （Pseudomonas aeruginosa）, 29 days （Enterobacter cloacae） and 26 days （coagulase negative Staphylococcus）, significantly longer than 18 days of non-MDROs （t = 9.03, P〈 0.001; t = 3.39, P = 0.001; t = 3.09, P = 0.002）. The total hospitalization/antibacterial drug expense multidrug-resistant bacteria were 86063/5506 RMB （Pseudomonas aeruginosa）, 48500/2402 RMB （Enterobacter cloacae） and 56221/2254 RMB （coagulase negative Staphylococcus）, significantly more than 23958/2024 RMB, 23741/1590 RMB and 20024/1318 RMB （all P ＆lt; 0.05）. Conclusions The MDROs related infections could increase the average hospital stay and the economic burden. It urgent to take effective management and control for health care associated infections and＆amp;nbsp;to improve the reasonable application of antimicrobial drug in order to lessen the economic burden.
作者
徐必生
袁华兵
杨萍
Xu Bisheng;Yuan Huabing;Yang Ping(President ＂s Office;Nosocomial Infection Control Department, 3Pharmacy Department, Tianmen the First People＇s Hospital, Tianmen 431700, China)
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2017年第5期455-459,共5页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
(中英)耐药菌医院感染疾病负担研究项目(No.2015-6SPF)
关键词
多重耐药菌
超广谱Β-内酰胺酶
医院感染
Multidrug-resistant bacteria
Extended spectrum beta-lactamases
Nosocomial infections
