某肿瘤医院多药耐药菌医院感染监测分析

[摘要] 目的 了解医院多药耐药菌（MDROs）感染现状，为预防控制医院多药耐药菌感染提供依据。 方法 对2010年1月～2011年12月实验室药敏报告中所有金黄色葡萄球菌、肠球菌属、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌进行前瞻性调查，以判定医院多药耐药菌感染情况。 结果 2010年1月～2011年12月住院患者中发生金黄色葡萄球菌、肠球菌属、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌感染 532例次，其中MDROs感染176例次，占比为33.1%。属于医院感染168例次，其中MDROs医院感染为77例次，占比为45.8%，MDROs医院感染科室以神经外科监护室最高，为62.5%，其次为肿瘤内科、放疗科。在医院感染部位中，以呼吸系统MDROs感染率最高，为57.3%。 结论 在多药耐药菌预防控制工作中，要重点关注神经外科的监护室、肿瘤内科、放疗科及呼吸系统感染。

[关键词] 多药耐药菌；肿瘤；医院感染；监测

[中图分类号] R97 [文献标识码] C [文章编号] 1673-7210（2012）08（b）-0116-03

Surveillance for nosocomial infections caused by multi-drug resistant bacteria in a cancer hospital

LI Hui LIU Xieping

Tumor Hospital Affiliated to Soochow University of Changzhou City, Jiangsu Province, Changzhou 213001, China

[Abstract] Objective To investigate the present situation of hospital-acquired multi-drug resistant organisms infections (MDROs-HAI), and to provide a reference for the prevention and control of hospital multidrug resistant bacteria infection. Methods To determine MDROs-HAI in the hospital, a prospective investigation of Staphylococcus aureus, Enterococcus, Escherichiacoli, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa in the laboratory antibiotic susceptibility report were conducted from January 2010 to December 2011. Results From January 2010 to December 2011, there were a total of 532 times infections caused by Staphylococcus aureus, Enter ococcus, Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae in the hospitalized patients. Among these infections, the MDROs infection was 176 cases, accounted for 33.1%, hospital infection was168 cases, while 77 cases belongs to the MDROs hospital infection, accounted for 45.8%. In all departments, the highest MDROs infection rate was department of neurosurgery, that was 62.5%. Second was department of medical oncology and radiation oncology. In the infection sites, the respiratory infection rate of the MDROs was highest, found in 57.3%. Conclusion Department of neurosurgery, department of oncology medicine, and department of radiotherapy should be paid more attention to in the prevention and the control of multi-drug resistant bacteria.

[Key words] Multidrug resistant organisms; Cancer; Hospital-acquired infection; Surveillance

临床上发生多药耐药菌（MDROs）甚至泛耐药菌的医院感染，是提高医疗质量、保障患者安全所面临的难题和最大的挑战，卫生部对此高度重视[1]。于2008年发文要求各级医疗机构加强对多药耐药菌的预防与控制工作，为切实做好此项工作，为临床用药及落实多药耐药菌感染防控措施提供科学依据。医院根据卫生部要求制定了具体的多药耐药菌监测管理制度，本调查针对近2年医院多药耐药菌感染监测与调查结果进行总结分析：