神经科重症监护病房医院感染多重耐药菌及综合干预效果

Multidrugresistant organisms causing healthcareassociated infection and comprehensive intervention in a neurological intensive care unit

摘要:

目的了解某院神经科重症监护病房（ICU）多重耐药菌（MDRO）感染情况，并评价综合干预措施效果。方法对某院2011年3—12月入住神经科ICU＞48 h的患者进行MDRO目标性监测，采取综合干预措施，比较干预前后MDRO感染情况。结果共监测住院患者932例，发生MDRO医院感染72例，发病率为7.73%；居前5位的MDRO为鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌。MDRO医院感染部位以下呼吸道为主，其次为泌尿道和血液系统。干预前MDRO检出率为11.70%（55株），干预后为3.68%（17株）, 干预前后检出率比较,差异有统计学意义(χ2=16.675, P＜0.001)。结论神经科ICU住院患者易感染MDRO，采取综合干预措施可以显著降低其医院感染发病率。

Abstract:

ObjectiveTo understand the infection caused by multidrugresistant organisms(MDROs) in a neurological intensive care unit (NeuroICU), and evaluate the effect of comprehensive intervention measures.MethodsTargeted monitoring on MDROs among patients who hospitalized in a NeuroICU for ＞48 hours between March and December 2011 was implemented, comprehensive intervention measures were taken, MDRO infection before and after intervention was compared.ResultsA total of 932 patients were monitored, 72 (7.73%) developed MDRO healthcareassociated infection(HAI); the top five MDROs were Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli. The main infection site of MDRO infection was lower respiratory tract, followed by urinary tract and bloodstream. Detection rates of MDROs before and after intervention were 11.70%(n=55) and 3.68%(n=17) respectively(χ2=16.675, P＜0.001).ConclusionPatients in NeuroICU are prone to develop MDRO infection, comprehensive intervention measures can reduce the incidence of HAI.