股骨骨折患者术后医院感染病原菌耐药特征与相关危险因素研究

发布时间：2018-03-02 15:49

本文选题：股骨骨折　切入点：医院感染　出处：《中华医院感染学杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨股骨骨折内固定术后医院感染病原菌特征及危险因素,为降低感染率提供依据。方法回顾性分析2012年8月-2015年3月医院收治的700例行内固定治疗股骨骨折患者临床资料,统计医院感染率、感染部位及病原菌耐药特征;并分析导致医院感染的独立危险因素。结果 700例患者中27例发生医院感染,感染率为3.9%;其中手术切口感染11例占40.7%,呼吸系统感染7例占26.0%,皮肤软组织感染6例占22.2%;共分离出病原菌35株,其中革兰阳性菌26株占74.3%,革兰阴性菌7株20.0%,真菌2株占5.7%;革兰阳性菌对青霉素、阿莫西林耐药率较高,分别为100.0%、87.5%,对万古霉素敏感性最高,敏感率为100.0%;革兰阴性菌对头孢吡肟、庆大霉素、诺氟沙星耐药率较高,为66.7%~100.0%,对亚胺培南和美罗培南敏感性最高,敏感率为100.0%;多因素回归分析显示,年龄、手术时间、基础疾病、开放性骨折、遗留死腔是导致股骨骨折内固定术后医院感染的独立危险因素。结论股骨骨折内固定术后医院感染主要病原菌为革兰阳性菌,临床上需要针对医院感染的危险因素制定相应的预防措施,以降低医院感染率。
[Abstract]:Objective to investigate the pathogenic bacteria characteristics and risk factors of nosocomial infection after internal fixation of femoral fractures. Methods the clinical data of 700 cases of femoral fracture treated by internal fixation from August 2012 to March 2015 were analyzed retrospectively, and the nosocomial infection rate, infection site and drug resistance of pathogenic bacteria were analyzed. The independent risk factors leading to nosocomial infection were analyzed. Results Nosocomial infection occurred in 27 out of 700 patients. The infection rate was 3.9.The infection rate of surgical incision infection was 40.7, respiratory infection was 26.0, skin and soft tissue infection was 22.22.35 strains of pathogenic bacteria were isolated. Among them, 26 strains of Gram-positive bacteria accounted for 74.3%, 7 strains for Gram-negative bacteria were 20.0, and 2 strains were fungi for 5.7.The resistance rate of Gram-positive bacteria to penicillin and amoxicillin was higher, which was 100.087.5%, respectively, and the sensitivity to vancomycin was 100.00.Gram-negative bacteria had the highest sensitivity to cefepime, and Gram-negative bacteria had the highest sensitivity to cefepime. The drug resistance rate of gentamicin and norfloxacin was high, which was 66.7% and 100.0.The sensitivity to imipenem and meropenem was the highest, and the sensitivity rate was 100.0.The multivariate regression analysis showed that age, operation time, basic diseases, open fracture, The left dead cavity is an independent risk factor for nosocomial infection after femoral fracture internal fixation. Conclusion the main pathogens of nosocomial infection after femoral fracture internal fixation are Gram-positive bacteria. In order to reduce the nosocomial infection rate, it is necessary to make corresponding preventive measures against the risk factors of nosocomial infection.
【作者单位】：新疆生产建设兵团第一师医院创伤骨科;
【基金】：新疆维吾尔自治区自然科学基金资助项目(2011211A054)
【分类号】：R446.5

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