国际流行病学传染病学杂志
國際流行病學傳染病學雜誌
국제류행병학전염병학잡지
International Journal of Epidemiology and Infectious Disease
2015年
4期
228-231
,共4页
林佩贤%黄宝添%许斐斐%林伟青
林珮賢%黃寶添%許斐斐%林偉青
림패현%황보첨%허비비%림위청
抗药性,多药%重症监护室%医院感染
抗藥性,多藥%重癥鑑護室%醫院感染
항약성,다약%중증감호실%의원감염
Drug resistance,multiple%Intensive care units%Hospital infection
目的 了解ICU中多重耐药菌(MDRO)所致医院感染的临床特点和耐药情况,为临床抗菌治疗、院内感染防控提供依据.方法 以ICU医院感染患者为调查对象,按是否为MDRO感染者分为病例组(60例)和对照组(35例),比较两组的临床特点、病原菌耐药情况和疾病负担.结果 95例医院感染患者共检出病原菌136株,其中60名患者检出MDRO菌株共94株.主要耐药菌株为鲍曼不动杆菌、铜绿假单胞菌和金黄色葡萄球菌,感染部位以肺部为主,共68株,占72.34％.鲍曼不动杆菌对抗菌药物普遍耐药,但对替加环素较敏感,耐药率为12.50％;铜绿假单胞菌对左氧氟沙星和亚胺培南耐药率较低,均为33.33％;金黄色葡萄球菌对呋喃妥因、利奈唑烷、万古霉素、替加环素、奎奴普丁/达福普汀、替考拉宁均敏感.病例组的急性生理与慢性健康评分(APACHEⅡ)及病死率分别为(23.05±8.45)分和25.00％,均明显高于对照组的(18.86±7.04)分和8.57％,差异有统计学意义(t=2.48,x2=3.88,P＜0.05);同时,与对照组相比,病例组住院时间更长,住院费用也更高(Z=2.26、2.55,P＜0.05).结论 ICU医院感染的病原体以MDRO居多,对大部分抗菌药物耐药.MDRO感染可导致患者病情加重,预后更差,经济负担更重.
目的 瞭解ICU中多重耐藥菌(MDRO)所緻醫院感染的臨床特點和耐藥情況,為臨床抗菌治療、院內感染防控提供依據.方法 以ICU醫院感染患者為調查對象,按是否為MDRO感染者分為病例組(60例)和對照組(35例),比較兩組的臨床特點、病原菌耐藥情況和疾病負擔.結果 95例醫院感染患者共檢齣病原菌136株,其中60名患者檢齣MDRO菌株共94株.主要耐藥菌株為鮑曼不動桿菌、銅綠假單胞菌和金黃色葡萄毬菌,感染部位以肺部為主,共68株,佔72.34％.鮑曼不動桿菌對抗菌藥物普遍耐藥,但對替加環素較敏感,耐藥率為12.50％;銅綠假單胞菌對左氧氟沙星和亞胺培南耐藥率較低,均為33.33％;金黃色葡萄毬菌對呋喃妥因、利奈唑烷、萬古黴素、替加環素、奎奴普丁/達福普汀、替攷拉寧均敏感.病例組的急性生理與慢性健康評分(APACHEⅡ)及病死率分彆為(23.05±8.45)分和25.00％,均明顯高于對照組的(18.86±7.04)分和8.57％,差異有統計學意義(t=2.48,x2=3.88,P＜0.05);同時,與對照組相比,病例組住院時間更長,住院費用也更高(Z=2.26、2.55,P＜0.05).結論 ICU醫院感染的病原體以MDRO居多,對大部分抗菌藥物耐藥.MDRO感染可導緻患者病情加重,預後更差,經濟負擔更重.
목적 료해ICU중다중내약균(MDRO)소치의원감염적림상특점화내약정황,위림상항균치료、원내감염방공제공의거.방법 이ICU의원감염환자위조사대상,안시부위MDRO감염자분위병례조(60례)화대조조(35례),비교량조적림상특점、병원균내약정황화질병부담.결과 95례의원감염환자공검출병원균136주,기중60명환자검출MDRO균주공94주.주요내약균주위포만불동간균、동록가단포균화금황색포도구균,감염부위이폐부위주,공68주,점72.34％.포만불동간균대항균약물보편내약,단대체가배소교민감,내약솔위12.50％;동록가단포균대좌양불사성화아알배남내약솔교저,균위33.33％;금황색포도구균대부남타인、리내서완、만고매소、체가배소、규노보정/체복보정、체고랍저균민감.병례조적급성생리여만성건강평분(APACHEⅡ)급병사솔분별위(23.05±8.45)분화25.00％,균명현고우대조조적(18.86±7.04)분화8.57％,차이유통계학의의(t=2.48,x2=3.88,P＜0.05);동시,여대조조상비,병례조주원시간경장,주원비용야경고(Z=2.26、2.55,P＜0.05).결론 ICU의원감염적병원체이MDRO거다,대대부분항균약물내약.MDRO감염가도치환자병정가중,예후경차,경제부담경중.
Objective To explore the clinical feature and antibiotic resistance of nosocomial infection caused by multi-drug resistant organisms (MDRO) in intensive care unit (ICU),and to provide reference for clinical treatment and prevention measure of hospital infection.Methods The nosocomial infection patients who stayed in ICU were investigated.According to whether infected by MDRO,the patients were divided into case group and control group.Clinical characteristics,antimicrobial resistance of pathogen,and burden of diseases were compared between two groups.Results A total of 136 strains of pathogen were detected from 95 patients.There were 94 strains of MDRO isolated from 60 patients.The main types of MDRO were Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus.Pulmonary infection was the principal infection site [68 strains (72.34％)].Acinetobacter baumannii strains were resistant to many antibiotics,but sensitive to glycylcycline,and the resistant rate was 12.50％.Pseudomonas aeruginosa strains were found low resistant rate to levofloxacin and imipenem,and the rate were both 33.33％.Staphylococcus aureus strains were sensitive to nitrofurantoin,linozelid,vancomycin,glycylcycline,quinupristin/dalfopristin and teicoplanin.The APACHE Ⅱ score and mortality rate of case group were (23.05±8.45) and 25.00％ respectively,and both higher than (18.86±7.04)and 8.57％ of control group.Those differences had statistical significance (t=2.48,x2=3.88,P＜0.05).Meanwhile,compared with control group,the hospitalization time of case group was longer,and cost was higher (Z=2.26,2.55,P＜0.05).Conclusions The pathogens caused hospital infection are MDROs mainly,and the bacteria resistant to most antibacterial agents.MDRO infection may lead to aggravation,worse prognosis and heavier financial burden.
