77例地震灾区受伤患者医院感染监控管理
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摘要
目的加强地震灾区受伤患者医院感染管理,防止灾区受伤患者多药耐药菌的传播,预防与控制医院感染暴发。方法对77例地震灾区受伤患者采取系列监控措施,进行实时监控。结果77例灾区受伤患者入院时基础感染53例,感染率为69.74%,送检标本83份,培养出病原菌共83株,革兰阳性球菌19株,其中耐甲氧西林金黄色葡萄球菌3株,耐甲氧西林表皮葡萄球菌7株,革兰阴性杆菌58株,鲍氏不动杆菌21株,多药耐药菌10株,ESBLs阳性大肠埃希菌10株,铜绿假单胞菌9株,真菌6株,革兰阳性球菌对青霉素、氨苄西林/舒巴坦、头孢唑林耐药率分别为89.47%、68.42%、89.47%;革兰阴性杆菌对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿奇霉素、妥布霉素、头孢西丁耐药率分别为37.93%、60.34%、48.83%、98.28%、98.28%、70.69%。结论基础感染病例多,耐药严重,严格执行标准预防和接触隔离,实时监控管理,无耐药菌株在医院内的传播及医院感染暴发流行。
OBJECTIVE To strengthen the management of earthquake victims with nosocomial infection,in order to prevent and control the multidrug-resistance transmission,and the nosocomial infection outbreak. METHODS All 77 earthquake victims were under real-time monitoring. RESULTS Of 77 cases,53 were infected (69.74%). From 83 samples,83 pathogenic bacteria were isolated. The Gram-positive cocci were 19 (meticillin-resistant Staphylococcus aureus 3,Meticillin-resistant S. epidermidis 7),58 were Gram-negative bacilli (Acinetobacter baumannii 21,multi-drug resistant strains 10,ESBLs positive Escherichia coli 10,Pseudomonas aeruginosa 9) and the fungi were 6 strains,The resistance rates of Gram-positive cocci to penicillin,ampicillin/sulbactam and cefazolin were 89.47%,68.42% and 89.47%; the resistance rates of Gram-negative bacillis to imipenem,cefoperazone/sulbactam,piperacillin/tazobactam,azithromycin,tobramycin,and cefoxitin were 37.93%,60.34%,48.83%,98.28%,98.28% and 70.69%,respectively. CONCLUSIONS Under the situation of higher infection rate and a serious drug resistance in earthquake area,there are no multidrug-resistance transmissionm and the spread of nosocomiol infection outbreak happened in hospital due to strictly enforced prevention meassures and access real-time monitoring and management,
引文
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