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目的了解四川省某三级甲等医院多重耐药菌(MDRO)感染现状和特点,分析实施综合防控干预措施所带来的干预效果,为临床MDRO感染的预防控制提供科学依据。方法 2015年1月开始实施针对MDRO的综合防控干预措施,通过多重耐药上报软件收集2014年1月-6月和2015年1月-6月的MDRO数据,分析比较MDRO感染情况,评价MDRO医院感染控制效果。结果 2014年上半年共24 709例住院患者,共813例次患者检出MDRO,其中医院感染MDRO 196例次,构成比24.10%,MDRO医院感染例次率0.79%,社区感染/定植MDRO 617例次,构成比75.90%;2015年上半年共25 329例住院患者,共739例次患者检出MDRO,其中医院感染MDRO 132例次,构成比17.86%,MDRO医院感染例次率0.52%,社区感染/定植MDRO 607例次,构成比80.14%;与2014年上半年相比,2015年上半年医院感染MDRO构成比下降,差异有统计学意义(χ2=9.062,P<0.001),MDRO医院感染例次率降低,差异有统计学意义(χ2=14.220,P<0.001);2015年上半年与2014年同期MDRO医院感染患者在科室分布、患者感染部位分布和检出病原菌方面差异均有统计学意义(P<0.05)。结论采取综合防控干预措施后该院MDRO医院感染控制情况得到改善,在今后MDRO医院感染控制工作中应着重关注重点科室、重要感染部位和主要耐药菌的预防控制。
Objective To understand the current status and characteristics of multidrug-resistant bacteria (MDRO) infection in a Class 3 Hospitals in Sichuan Province and to analyze the intervention effect brought by the implementation of comprehensive prevention and control interventions, so as to provide a scientific basis for the prevention and control of clinical MDRO infection. Methods A comprehensive prevention and control intervention for MDRO was started in January 2015. The MDRO data collected in January-June 2014 and January-June 2015 were collected through multiple drug resistance reporting software. The MDRO data were analyzed and compared to evaluate the MDRO Hospital infection control effect. Results In the first half of 2014, a total of 24 709 inpatients were enrolled. A total of 813 patients were found to have MDRO. Among them, 196 were hospital-acquired MDROs, constituting 24.10% of patients, 0.79% of MDRO hospital infections and 617 of community-acquired infections / colonization MDROs 25,75 cases were hospitalized in the first half of 2015. A total of 739 patients were found to have MDRO. Among them, 132 cases were hospital-acquired MDRO, accounting for 17.86%, and the incidence of MDRO hospital infection was 0.52%. Community Infectious / colonization of MDRO 607 cases, the constituent ratio of 80.14%; compared with the first half of 2014, the first half of 2015 decreased the proportion of hospital infection MDRO, the difference was statistically significant (χ2 = 9.062, P <0.001), MDRO hospital infection (Χ2 = 14.220, P <0.001). In the first half of 2015 and the same period of 2014, there was a statistically significant difference in the distribution of MDRO hospital infection among departments, the distribution of the infected sites and the detection of pathogens Significance (P <0.05). Conclusion The control of MDRO hospital infection in this hospital is improved after comprehensive prevention and control intervention. In the future MDRO hospital infection control, we should pay attention to the prevention and control of key departments, important infection sites and major drug-resistant bacteria.