2026 年第 4 期 第 21 卷

多重耐药菌早期预警评估表在重症监护病房患者医院感染防控中的应用研究

Application of the multidrug-resistant organism early warning assessment scale in the prevention and control of nosocomial infections in intensive care unit patients

作者：梁雪妃张晓璇郭力恒何健卓陈名桂杨帅王芳芳李醒龙吴清娇

英文作者：Liang Xuefei Zhang Xiaoxuan Guo Liheng He Jianzhuo Chen Minggui Yang Shuai  Wang Fangfang Li Xinglong Wu Qingjiao

单位：广州中医药大学第二附属医院（广东省中医院）重症医学科，广州510120

英文单位：Department of Critical Care Medicine the Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine) Guangzhou 510120 China

关键词：多重耐药菌；预警评估；重症监护病房；医院感染；防控策略 

英文关键词：Multidrug-resistantorganism;Earlywarningassessment;Intensivecareunit;Nosocomialinfections;Preventionandcontrolstrategies

• 摘要：

• 目的 探讨多重耐药菌（MDRO）早期预警评估表在重症监护病房（ICU）新入科患者中的应用效果。方法 选取2021年8月至2025年2月广东省中医院重症医学科收治的110例患者，采用包含患者来源、住院天数、年龄、管道留置时长、高危因素5项核心指标的风险评估表进行前瞻性观察性研究。采用受试者工作特征曲线分析确定评估表的最佳截断值，以约登指数最大化为原则，确定的最佳临界值为9分（曲线下面积为0.78）。根据评分将患者分为高风险组（≥9分）与低风险组（≤8分），比较2组MDRO检出率的差异。结果 高风险组的MDRO检出率显著高于低风险组［76.2%（32/42）比35.3%（24/68）］，差异有统计学意义（P＜0.001）。所有患者共分离出病原菌194株，其中MDRO菌株为89株（45.9%），前4位检出菌种为肺炎克雷伯菌（22株）、大肠埃希菌（15株）、金黄色葡萄球菌（12株）和鲍曼不动杆菌（12株），混合感染率为30.9%（34/110）。结论 MDRO早期预警评估表能有效识别ICU新入科患者中的MDRO高风险人群，对评分≥9分者实施预隔离措施具有重要的临床价值。

• Objective To investigate the application effect of the multidrug-resistant organism (MDRO) early warning assessment scale in newly admitted patients to the intensive care unit (ICU). Methods A prospective observational study was conducted on 110 patients admitted to the Department of Critical Care Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine from August 2021 to February 2025, using a risk assessment scale containing five core indicators: patient source, length of hospital stay, age, duration of indwelling catheter, and high-risk factors. Receiver operating characteristic curve analysis was used to determine the optimal cut-off value of the assessment scale. Based on the principle of maximizing the Youden index, the optimal critical value was determined to be 9 (the area under the curve was 0.78). Patients were divided into the high-risk group (≥9) and the low-risk group (≤8) according to the scores, and the difference in the MDRO detection rate between the two groups was compared. Results The MDRO detection rate in the high-risk group was significantly higher than that in the low-risk group ［76.2%(32/42) vs 35.3%(24/68)］(P＜0.001). A total of 194 pathogenic strains were isolated from all patients, among which 89 were MDRO strains (45.9%). The top four detected strains were Klebsiella pneumoniae (22 strains), Escherichia coli (15 strains), Staphylococcus aureus (12 strains) and Acinetobacter baumannii (12 strains). The rate of mixed infection was 30.9%(34/110). Conclusion The MDRO early warning assessment scale can effectively identify the high-risk population of MDRO among newly admitted ICU patients, and the implementation of pre-isolation measures for patients with a score of ≥9 points has important clinical value.