摘要
目的了解中西医结合科（姑息病房）病原菌的分布特征和耐药现状、抗菌药物的应用情况及感染控制效果。方法于2012年5月~2014年4月每月按期登记新疆医科大学附属肿瘤医院中西医结合科（姑息病房）的感染防控质量工作手册,详细记录科室所收患者的感染状况与感染防控配套的相关措施的实施情况,所选样本分离出的病原菌用自动细菌鉴定仪VITEK 2 Compact进行鉴定及药敏试验。结果 2年来,科室抗生素的使用率为14.59%,每月使用强度为7-15 DDD,隔离控制率为97.2%,感染控制率为87.62%。病原菌的分布为：大肠杆菌24.90%,铜绿假单胞菌12.45%,肺炎克雷伯菌11.67%,鲍曼不动杆菌9.34%,阴沟肠杆菌5.45%,其他1.56%。金黄色葡萄球菌9.34%,表皮葡萄球菌5.06%,粪肠球菌4.28%,白色假丝酵母菌7.00%,热带假丝酵母菌3.11%,光滑假丝酵母菌3.50%,克柔假丝酵母菌2.33%。对革兰氏阴性杆菌耐药率低的抗菌药物有亚胺培南、美罗培南、丁胺卡那霉素、头孢哌酮/舒巴坦。对革兰氏阳性球菌耐药率低的抗菌药物有利奈唑胺、万古霉素、替加环素、莫西沙星。结论肿瘤姑息病房感染防控质量依赖于病原菌监测、抗菌药物的合理使用,配套的感染隔离、手卫生、定植菌的清除,患者原发病的控制,患者营养状况的改善,中医药的辅助治疗等协作配合。
Objective To understand the distribution characteristics and status quo of drug resistance of isolated pathogenic bacteria, the application status of antibiotics and the effect of infection control in the department of integrated traditional Chinese and Western Medicine（palliative wards）. Methods From May 2012 to April 2014, we registered on schedule each month on the infection prevention and control manual of the palliative wards, and recorded in detail the infection condition and implement of related measures for the prevention and control of infection of patients admitted to the department. Automatic bacterial identification instrument VITEK 2 Compact was used for identification and drug sensitivity test of pathogenic bacteria isolated from selected samples. Results Within 2 years, the antibiotic use rate of department was 14.59%, the monthly use intensity was 7-15 DDD, isolation control rate was 97.2 %, infection control rate was 87.62%, the distribution of pathogenic bacteria were as follows： Escherichia coli（24.90%）, Pseudomonas aeruginosa（12.45%）, Klebsiella pneumonia（11.67%）, Bauman Acinetobacter（9.34%）, Enterobacter cloacae（5.45%）, others（1.56%）; Staphylococcus aureus（9.34%）, Staphylococcus epidermidis（5.06%）, Enterococcus faecalis（4.28%）, Candida albicans（7%）, Candida tropicalis（3.11%）, Candida glabrata（3.50%）, Candida krusei（2.33%）. Imipenem, meropenem, amikacin, Cefoperazone/sulbactam had low resistance rate to Gram-negative bacillus, while linezolid, vancomycin, tigecycline, moxifloxacin had low resistance rate of to Gram-positive cocci. Conclusion The quality of infection prevention in Palliative ward depends on collaboration work of many aspects such as good pathogenic bacteria monitoring, reasonable use of antibiotics, matched isolation, hand hygiene, removal of colonization bacteria, control of primary disease, improvement of the patients＇ nutritional status and TCM therapy.
出处
《肿瘤药学》
CAS
2015年第2期146-150,共5页
Anti-Tumor Pharmacy
关键词
姑息病房
病原菌监测
抗菌药物应用
Palliative ward
Pathogen monitoring
Application of antibiotics
