覃桂芝

[摘要] 目的 分析住院患者多重耐药菌（MDRO）感染的临床特点，采取相应的护理干预措施，降低其感染率。方法 方便选择该院2017年1月—2018年7月收治的细菌型感染患者100例作为研究对象，分析多重耐药菌的性状特点，同时针对护理干预措施。结果 100例患者标本中分离出致病菌136株，其中多重耐药菌株有94株.占所有致病菌的67.14%，多重耐药菌大部分存在于人体血液、呼吸道以及分泌物中.在使用抗菌类药物以后，进行药敏实验，结果表明.鲍曼不动杆菌的耐药性很强，对亚胺培南的耐药程度达到了88.6%以上，对头孢的耐药性为21.8%。在革兰阴性菌鉴定中，阴性耐药菌对头孢类药物耐药性较强，而且对多黏菌群比较敏感：在革兰阳性菌鉴定中，金黄色葡萄球菌对青霉素、红霉素类药物较为耐药。结论 落实多重耐药菌的管理制度，完善管理体系，及时汇报，合理应用抗生素，加强用药护理，严格执行护理操作，加强防范措施，做好病区管理、消毒隔离等对有效控制多重耐药菌感染具有重要的临床意义。

[关键词] 多重耐药菌;致病菌;临床特征;对策

[Abstract] Objective To analyze the clinical characteristics of multidrug-resistant bacteria（MDRO） infection in hospitalized patients and take corresponding nursing intervention measures to reduce their infection rate. Methods A total of 100 patients with bacterial infections treated in the hospital from January 2017 to July 2018 were convenienty selected as research objects. The characteristics of multi-drug resistant bacteria were analyzed， and nursing intervention measures were targeted. Results 136 isolates of pathogenic bacteria were isolated from 100 patients， 94 of which were multi-drug resistant strains. It accounted for 67.14% of all pathogenic bacteria， and most of the multi-resistant bacteria are present in human blood， respiratory tract and secretions. After the use of antibacterial drugs， drug sensitivity tests were performed， and the results showed that， the resistance to Acinetobacter baumannii was very strong， the degree of resistance to imipenem reached more than 88.6%， and the resistance to cephalosporins was 21.8%. In the identification of Gram-negative bacteria， negative drug-resistant bacteria are more resistant to cephalosporins and more sensitive to polymyxa： in the identification of Gram-positive bacteria， Staphylococcus aureus is more resistant to penicillin and erythromycin drugs. Conclusion Implement the management system of multi-drug resistant bacteria， improve the management system， report in a timely manner， rationally apply antibiotics， strengthen medication care， strictly implement nursing operations， strengthen preventive measures， do well in ward management， disinfection and isolation to effectively control multi-drug resistance Bacterial infection， which has important clinical significance.

[Key words] Multidrug-resistant bacteria; Pathogenic bacteria; Clinical characteristics; Countermeasures

多重耐藥菌指对3种或者3种以上抗菌类药物均呈现出耐药特征的细菌，从而引发患者感染。近几年来.抗生素类药物应用范围非常广，被多重耐药菌（MDRO）所感染的患者人数也呈现出了上升趋势，这类菌株的耐药性非常强.治疗较困难。鉴于目前国内用药形势，多重耐药菌已广泛存在，并在临床治疗中起到了很大的阻碍作用。……