恶性肿瘤患者多重耐药菌医院感染监测与干预效果

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目的研究住院恶性肿瘤患者多重耐药菌(MDROs)医院感染及其干预效果。方法通过目标性监测方法,对某医院恶性肿瘤住院患者MDROs医院感染进行调查,分析感染危险因素,实施综合干预措施。结果该医院2年间收治恶性肿瘤住院患者55 336例,发生MDROs感染患者69例,感染率为0.12%。实施目标性监测的2014年度MDROs感染率明显低于2013年,呈下降趋势。从69例MDROs感染患者送检标本中分离出的病原菌主要是大肠埃希菌和葡萄球菌属,构成比分别为53.62%和30.44%。病原菌主要分离自血液,占27.54%;其次为痰液和引流液,分别占23.19%和18.84%。MDROs感染部位以手术部位、血液和呼吸道感染为主,构成比分别占26.09%、23.19%和20.29%。结论恶性肿瘤患者MDROs感染主要发生在手术部位、血液和呼吸道,病原菌以大肠埃希菌和葡萄球菌属为主,应结合此特点有针对性地加强预防和控制。 Objective To study the hospital infection of multidrug-resistant bacteria (MDROs) in hospitalized patients with malignant tumor and the effect of intervention. Methods By means of targeted monitoring, we investigated the MDROs inpatients with malignant tumors in a hospital and analyzed the risk factors of infection and implemented the comprehensive interventions. Results A total of 55 336 hospitalized patients with malignant tumors were admitted to the hospital in 2 years. 69 patients were infected with MDROs and the infection rate was 0.12%. The infection rate of MDROs in implementing targeted monitoring in 2014 was significantly lower than that in 2013, showing a downward trend. The pathogens isolated from 69 samples of MDROs infected patients were mainly Escherichia coli and Staphylococcus, with the proportions of 53.62% and 30.44%, respectively. Pathogenic bacteria were mainly isolated from blood, accounting for 27.54%; followed by sputum and drainage fluid, accounting for 23.19% and 18.84% respectively. The infection sites of MDROs were mainly surgical sites, blood and respiratory infections, accounting for 26.09%, 23.19% and 20.29% respectively. Conclusions MDROs in malignant tumors mainly occur in the surgical site, blood and respiratory tract. Escherichia coli and Staphylococcus are the main pathogenic bacteria in the malignant tumor. The prevention and control should be strengthened according to the characteristics.
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