院内鲍曼不动杆菌感染流行病学调查分析
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摘要
目的研究鲍曼不动杆菌感染相关危险因素及耐药特点。方法对某综合性三级甲等医院近两年发生100例鲍曼不动杆菌医院感染患者按1:1配对进行病例对照研究,危险因素分析采用条件Logistic回归分析。结果鲍曼不动杆菌医院感染患者科室分布依次为重症医学科、呼吸内科、神经内科、神经外科及普外科。其危险因素为使用呼吸机(OR=10.676)、抗菌药物使用≥14d(OR=9.640)、基础疾病(OR=8.071)、使用深静脉插管(OR=7.752)、留置导尿(OR=6.206)。药敏试验结果显示鲍曼不动杆菌仅对米诺环素及多粘菌素B保持低耐药率(<5%),对其余抗菌药物耐药率均超过50%。结论鲍曼不动杆菌已成为医院感染的重要致病菌,其感染率及耐药率日趋严重,医院感染管理部门应指导临床科室做好医院感染防控工作,防止鲍曼不动杆菌感染在医院内流行暴发。
Objective Research related risk factors and drug resistance of Bauman infection,Formulate related hospital infection control measures of Bauman,To provide the basis for clinical treatment and prevention of infection. Methods Use the casecontrol study to 100 cases Bauman hospital infection patients by 1:1 matched occurred nearly two years in a comprehensive three A-level hospitals,The risk factors were analyzed by conditional Logistic regression analysis. Results The distribution of the hospital infection of Acinetobacter Bauman were in turn as the critical medical department,Department of Respiratory Medicine,Department of Neurology,Department of Neurosurgery and Department of General Surgery. The risk factors were the ventilator(OR=10.676),Antimicrobial drug using over 14 days(OR=9.640),Basic disease(OR=8.071),using deep vein catheterization(OR=7.752)and indwelling cat-heter(OR=6.206). Polymyxin B and minocycline showed Low drug resistance in drug sensitive test(<5%),The rest of the antimicrobial resistance rates were above 50%. Conclusion Bauman has become the main pathogens of hospital infection,The infection rate and drug resistance rate are becoming more and more serious,Department of hospital infection should guide the clinical departments to do a good job in prevention and control of hospital infection,prevent Bauman infection outbreak in the hospital.
Objective Research related risk factors and drug resistance of Bauman infection,Formulate related hospital infection control measures of Bauman,To provide the basis for clinical treatment and prevention of infection. Methods Use the casecontrol study to 100 cases Bauman hospital infection patients by 1:1 matched occurred nearly two years in a comprehensive three A-level hospitals,The risk factors were analyzed by conditional Logistic regression analysis. Results The distribution of the hospital infection of Acinetobacter Bauman were in turn as the critical medical department,Department of Respiratory Medicine,Department of Neurology,Department of Neurosurgery and Department of General Surgery. The risk factors were the ventilator(OR=10.676),Antimicrobial drug using over 14 days(OR=9.640),Basic disease(OR=8.071),using deep vein catheterization(OR=7.752)and indwelling cat-heter(OR=6.206). Polymyxin B and minocycline showed Low drug resistance in drug sensitive test(<5%),The rest of the antimicrobial resistance rates were above 50%. Conclusion Bauman has become the main pathogens of hospital infection,The infection rate and drug resistance rate are becoming more and more serious,Department of hospital infection should guide the clinical departments to do a good job in prevention and control of hospital infection,prevent Bauman infection outbreak in the hospital.
引文
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[6]Falagas ME,Koletsi PK,Bliziotis IA.The diversity of definitions of muhidrug-resistant(MDR)and pandrug-resistant(PDR)Acinetoba￣cter baumannii and Pseudomonas aeruginosa[J].J Med Microbiol,2006,55:1619-1629.
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[9]赖智双,陈愉生,石松菁,等.内科重症监护室鲍曼不动杆菌医院感染危险因素病例对照研究[J].中国感染控制杂志,2010,9(1):10-14.
[10]段秀杰,陆建成,阴晴,等.重症监护病房鲍曼不动杆菌感染调查及泛耐药情况分析[J].中国现代医学杂志,2010,20(2):244-247.
[11]卢才菊,王永,周菁.我院鲍曼不动杆菌的耐药性分析[J].江西医药,2011,46(9):863-864.
[2]涂建斌,饶丽华,沈思瑶.鲍曼不动杆菌感染的临床特征及耐药性监测[J].江西医药,2014,49(7):579-581.
[3]中华人民共和国卫生部.医院感染诊断标准(试行)[S].北京:中华人民共和国卫生部.2001.1.
[4]殷网虎,曹美林,邓慧,等.鲍曼不动杆菌生物膜形成与耐药关系研究[J].江西医药,2016,51(3):275-277.
[5]张玲,尚碧莲,欧阳玲,等.重症监护室鲍曼不动杆菌感染及耐药情况的分析[J].临床医学和实验医学杂志,2012,11(1):25-27.
[6]Falagas ME,Koletsi PK,Bliziotis IA.The diversity of definitions of muhidrug-resistant(MDR)and pandrug-resistant(PDR)Acinetoba￣cter baumannii and Pseudomonas aeruginosa[J].J Med Microbiol,2006,55:1619-1629.
[7]Paterson DL,Doi Y.A step closer to extreme drug resistance(XDR)in gram-negative bacilli[J].Clin Infect Dis,2007,45:1179-1181.
[8]蒋景华,庄晓伟.重症监护病房鲍曼不动杆菌医院感染危险因素[J].中国消毒学杂志,2011,28(1):38-41.
[9]赖智双,陈愉生,石松菁,等.内科重症监护室鲍曼不动杆菌医院感染危险因素病例对照研究[J].中国感染控制杂志,2010,9(1):10-14.
[10]段秀杰,陆建成,阴晴,等.重症监护病房鲍曼不动杆菌感染调查及泛耐药情况分析[J].中国现代医学杂志,2010,20(2):244-247.
[11]卢才菊,王永,周菁.我院鲍曼不动杆菌的耐药性分析[J].江西医药,2011,46(9):863-864.