2023-2024年某综合医院多重耐药菌目标性监测报告

Targeted surveillance reports of multidrug-resistant organism in a general hospital from 2023 to 2024

  • 摘要:
    目的 探究某三甲医院连续两年多重耐药菌(MDRO)目标性监测情况,为制定MDRO防控策略提供科学参考依据。
    方法 收集联勤保障部队第九二〇医院2023-2024年住院患者5种重点MDRO检出数据,分析MDRO感染发生率、检出率、MDRO分布特征及来源。
    结果 2023-2024年,住院患者共145 915例,MDRO感染者1 605例,感染发生率为1.10%。两年间MDRO总检出率为12.37%,其中2023年检出率为11.74%,2024年检出率为13.09%,两年的检出率差异有统计学意义(P=0.004)。在MDRO的构成中,2023-2024年耐碳青霉烯类肠杆菌科细菌(CRE)检出占比最高(43.32%)、其次为耐碳青霉烯类鲍曼不动杆菌(CRAB, 40.87%)和耐碳青霉烯类铜绿假单胞菌(CRPA, 15.39%);2023-2024年MDRO检出量排名前三的科室依次是神经外科(15.73%)、老年重症监护病区(12.19%)和重症医学科(11.56%)。CRE、CRAB和CRPA主要分离自痰液。
    结论 尽管MDRO感染发生率略有下降,但耐药形势仍然严峻,CRE应作为重点防控的MDRO。今后需继续强化目标性监测工作,加强对MDRO检出高危科室防控措施落实的督查,以有效措施控制MDRO传播。

     

    Abstract:
    OBJECTIVE To investigate the targeted surveillance of multidrug-resistant organism (MDRO) over two consecutive years in a three-A hospital, providing a scientific reference for formulating MDRO prevention and control strategies.
    METHODS The data regarding 5 major types of MDROs from inpatients at the No. 920 Hospital of the PLA Joint Logistics Support Force from 2023 to 2024 were collected, and the incidence rate, detection rate, distribution characteristics and sources of MDRO infections were analyzed.
    RESULTS From 2023 to 2024, there were 145 915 inpatient cases, with 1 605 MDRO infections, resulting in an infection incidence rate of 1.10%. The overall MDRO detection rate over the two years was 12.37%, with a detection rate of 11.74% in 2023 and 13.09% in 2024, showing a statistically significant difference between the two years (P=0.004). Among the MDRO, carbapenem-resistant Enterobacteriaceae (CRE) had the highest detection proportion (43.32%) from 2023 to 2024, followed by carbapenem-resistant Acinetobacter baumannii (CRAB, 40.87%) and carbapenem-resistant Pseudomonas aeruginosa (CRPA, 15.39%). The top three departments with the highest MDRO detection volumes from 2023 to 2024 were neurosurgery (15.73%), geriatric intensive care unit (12.19%) and critical care medicine (11.56%). CRE, CRAB and CRPA were mainly isolated from sputum.
    CONCLUSIONS Although the incidence rate of MDRO infections has slightly decreased, the resistance situation remains severe, with CRE being the priority MDRO for prevention and control. In the future, it is necessary to continue strengthening targeted surveillance efforts and enhancing supervision over the implementation of prevention and control measures in high-risk departments for MDRO detection to effectively control the spread of MDRO.

     

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