重症监护病房多重耐药菌监测与控制现状分析

目的了解北京市三级医院重症监护病房(ICU)多重耐药菌监测及防控措施落实情况。方法制定统一调查表,对北京市38家三级医院的ICU进行现场评估。结果38家三级医院中有35家医院的ICU开展了多重耐药菌监测;监测占首位的多重耐药菌排名为泛耐药鲍曼不动杆菌、耐甲氧西林金黄色葡萄球菌(MRSA)、耐碳青霉烯铜绿假单胞菌、产ESBLs肺炎克雷伯菌、产ESBLs大肠埃希菌。79.0%的ICU单人间病房数量不超过5个。78.9%的医院基本能做到对多重耐药菌感染患者和普通患者分开管理。结论多重耐药的革兰阴性杆菌是ICU最常见的病原菌。医疗资源不足加大了多重耐药菌医院感染防控的难度。

Study on Surveillance and Control of Multidrug-resistant Bacteria in Intensive Care Unit

Objective To investigate the current status of surveillance of multidrug resistant bacteria and fulfillment about control measures in Beijing＇s Tertiary Care Hospitals＇ ICUs. Methods Though designing generic evaluation forms 38 Beijing＇ s tertiary care hospitals＇ ICUs were evaluated onsite. Results In 38 tertiary care hospitals, 35 hospitals carry out surveillance about multidrugresistant bacteria. Ranking list of multidrug resistant bacteria is pan resistant acinetobacter baumannii, methicillin resistant staphylococcus, pseudomonas aeruginosa, klebsiella pneumoniae and escherichia coli. 78.9% hospital can separate patients who infected multidrug resistant bacteria with general patients. Conclusion Situation about bacterial resistance is serious. Multidrug resistant gram-negative bacteria are commonest pathogenic bacteria in ICU. Insufficiency of medical resources increases difficulty about nosocomial infection control of multidrug resistant bacteria.