目的：了解多重耐药菌（MDRO ）感染类型及变化趋势，为 MDRO 医院感染的预防与控制提供依据。方法对某三级甲等综合教学医院2010年10月1日-2013年9月30日分离的细菌及MDRO进行分析。结果共分离细菌5223株，MDRO 占23．22％（1213株）。经趋势χ2检验，MDRO 所占比例逐年上升（χ2＝16．885，P＜0．001）。1213株MDRO中，医院感染455株（37．51％），社区感染613株（50．54％），定植112株（9．23％），污染33株（2．72％）。2010-2013年，MDRO医院感染所占比例呈下降趋势（χ2＝13．477，P＜0．001），社区感染（χ2＝6．579，P＝0．01）及定植（χ2＝4．536，P＝0．033）所占比例呈上升趋势。感染部位以呼吸系统（997株，84．49％）为主，其次为泌尿系统、皮肤和软组织、血液系统等。结论 MDRO感染形势严峻，其社区感染及定植患者的管理成为医院感染预防与控制的重点。%Objective To realize types and changing trends of multi-drug resistant organism(MDROs)infection,so as to provide reference for preventing and controlling MDRO healthcare-associated infection (HAI). Methods Bacteria and MDROs isolated from patients in a general hospital from October 1 ,2010 to September 30,2013 were analyzed. Results A total of 5 223 bacteria strains were isolated,1 213 (23.22% )of which were MDROs.χ2 trend test showed that the percentage of MDROs increased year by year (χ2= 16.885,P<0.001).Of all MDROs,rate of HAI strains ,community-associated infection (CAI)strains,colonized strains ,and contamination strains were 37.51% (n= 455),50.54% (n= 613),9.23% (n= 112),and 2.72% (n= 33)respectively . From 2010 to 2013, the percentage of MDRO HAI showed decreased trend (χ2= 13.477,P<0.001),CAI and colonization showed in-creased trend (χ2= 4.536,P= 0.033),the main infection site was respiratory tract(84.49% ,n= 997),followed by urinary tract ,skin and soft tissue,and bloodstream. Conclusion MDRO infection become more and more serious, management of patients with MDRO CAI and colonization has become the focus of HAI prevention and control.
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