摘要
目的了解综合性中医院碳青霉烯耐药肠杆菌科细菌(carbapenem-resistant Enterobacteriaceae,CRE)分布特点和医院感染情况,为多重耐药菌感控管理工作提供依据。方法回顾性分析2014年-2018年安徽中医药大学第一附属医院检出的CRE监测资料。结果2014年-2018年CRE检出率分别为10.76%、5.58%、15.42%、12.94%、16.18%,检出率呈现逐渐上升趋势(χ^2=29.940,P<0.001)。临床标本中分离出CRE最高是痰液[355株(63.39%)],其次是尿液[98株(17.50%)]、分泌物[38株(6.79%)]。临床科室分离出CRE主要在神经外科[172株(30.71%)]、重症监护病房(内科)[145株(25.89%)]、重症监护病房(外科)[106株(18.93%)]、其他内科科室[83株(14.82%)]。5年来共有179例患者发生CRE医院感染,感染患者以男性、高龄、住院时间长、有基础疾病、免疫功能异常和侵入性操作为主。2014年-2018年CRE医院感染发病率分别为0.31‰、0.38‰、0.89‰、0.80‰、1.14‰,呈现出上升趋势(χ^2=25.111,P<0.001)。结论随着临床分离的CRE菌株不断增多,CRE医院感染发病率不断上升,需要采取有效的干预措施预防和控制CRE。
Objective To understand the distribution characteristics and nosocomial infection of carbapenemresistant Enterobacteriaceae(CRE)in a general hospital of traditional Chinese medicine,so as to provide the evidence for control and management of multidrug-resistant bacteria.Methods Data of CRE in the first Affiliated Hospital of Anhui University of Traditional Chinese Medicine were analyzed retrospectively from 2014 to 2018.Results The total detection rate of CRE was 10.76%,5.58%,15.42%,12.94%and 16.18%from 2014 to 2018,respectively.The detection rate of CRE showed a gradual upward trend(χ^2=29.940,P<0.001).The highest number of CRE isolated from clinical specimens was sputum(355 strains,63.39%),and the next were urine(98 strains,17.50%)and secretions(38 strains,6.79%).CRE isolated from different clinical departments were mainly in Neurosurgery Department(172 stains,30.71%),Intensive Care Unit(Internal Medicine)(145 strains,25.89%),Intensive Care Unit(Surgery)(106 strains,18.93%),and other internal medical departments(83 strains,14.82%).A total of 179 patients developed CRE nosocomial infection in the past 5 years,who were mainly male,and with advanced age,long hospital stay,basic diseases,abnormal immune function and invasive operation.The incidence of hospital infection with CRE from 2014 to 2018 were 0.31‰,0.38‰,0.89‰,0.80‰and1.14‰,respectively,which also showed a gradual upward trend(χ^2=25.111,P<0.001).Conclusion With the increasing number of clinically isolated CRE strains and the increasing incidence of nosocomial infection of CRE,effective intervention measures should be taken to prevent and control CRE.
作者
何倩
赵红
柯银凤
张昌峰
李晓娜
徐玉菲
HE Qian;ZHAO Hong;KE Yinfeng;ZHANG Changfeng;LI Xiaona;XU Yufei(Hospital Infection Management Section,First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Anhui,Hefei 230031,P.R.China;Microbiology Room,First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Anhui,Hefei 230031,P.R.China;Department of Economics and Management,First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Anhui,Hefei 230031,P.R.China)
出处
《华西医学》
CAS
2020年第3期301-306,共6页
West China Medical Journal
基金
安徽中医药大学科研项目(2018zryb47)。
关键词
多重耐药菌
碳青霉烯耐药肠杆菌科细菌
医院感染
Multidrug-resistant bacteria
Carbapenem-resistant Enterobacteriaceae
Nosocomial infection
