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目的分析近3年以来该院神经内科多重耐药菌感染变化情况,探讨在这一变化下应采取的应对措施。方法选择2012年1月-2015年4月期间该院神经内科临床分离的菌株进行研究,以时间界限为依据进行分组,2012年1-12月分离的菌株为A组,2013年1-12月分离的菌株为B组,2014年1月-2015年4月分离的菌株为C组,观察多重耐药菌感染率、感染部位和菌株构成变化情况,探讨应对措施。结果 A、B、C三组细菌感染率分别为4.98%、3.47%、3.41%,多重耐药菌感染率分别为1.28%、0.79%、0.75%,该院神经内科细菌感染率和多重耐药菌感染均呈下降趋势,但变化无明显的统计学意义(P>0.05);感染部位均以呼吸道感染为主,组间比较无明显的统计学差异(P>0.05);细菌感染菌株构成情况组间比较无明显的统计学意义(P>0.05);革兰阳性菌以金黄色葡萄球菌为主,革兰阴性菌以大肠杆菌为主;鲍曼不动杆菌和绿脓杆菌有上升趋势,但组间比较无明显的统计学意义(P>0.05)。结论自2012年以来,该科室细菌感染率和多重耐药菌感染率均有所下降,但下降不明显,仍然面临严峻的挑战,建议应严格规范抗生素的使用,尽可能减少侵入性操作。
Objective To analyze the changes of multidrug-resistant bacterial infections in neurology department of the hospital since the past 3 years and to discuss the countermeasures to be taken under this change. Methods From January 2012 to April 2015, the clinical isolates from the department of neurology of the hospital were selected and divided into groups based on the time limit. The isolates from January to December in 2012 were group A, January to December in 2013 The isolated strains were Group B, and the strains isolated from January 2014 to April 2015 were Group C, the infection rate of multidrug-resistant bacteria, the infection site and the composition of the strains were observed and the response measures were discussed. Results The rates of bacterial infections in groups A, B and C were 4.98%, 3.47% and 3.41%, respectively. The infection rates of multidrug-resistant bacteria were 1.28%, 0.79% and 0.75% respectively. The rates of bacterial infection and multiple drug resistance (P> 0.05). The infection sites were mainly respiratory tract infection with no statistical difference (P> 0.05). The composition of bacterial infection strains Gram-positive bacteria were Staphylococcus aureus, Gram-negative bacteria were Escherichia coli; Acinetobacter baumannii and Pseudomonas aeruginosa were on the rise, However, there was no significant difference between groups (P> 0.05). Conclusions Since 2012, the bacterial infection rate and multi-drug-resistant bacterial infection rate in this department have declined, but the decline is not obvious, and still faces severe challenges. It is suggested that the use of antibiotics should be strictly regulated and the invasive operation should be minimized.