脑梗死患者继发褥疮感染的病原菌调查

发布时间：2018-03-03 15:21

本文选题：脑梗死　切入点：褥疮感染　出处：《中华医院感染学杂志》2016年17期 　论文类型：期刊论文

【摘要】：目的探讨脑梗死患者褥疮感染的病原学及其护理干预的应用效果,为临床上提高脑梗死患者的护理效果提供参考依据。方法选取医院2012年10月-2015年9月脑梗死合并褥疮感染的患者156例,搜集其感染部位分泌物标本进行培养,采用法国生物梅里埃公司Vitek-2Compact型细菌鉴定及药敏性分析仪进行鉴定分析,根据药敏试验结果制定其预防策略,进行针对性治疗,并辅以优质的护理干预。结果脑梗死合并褥疮感染患者标本中共分离出病原菌148株,其中革兰阴性菌76株占51.35%,以铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌为主,革兰阳性菌60株占40.54%,以金黄色葡萄球菌、粪肠球菌、表皮葡萄球菌为主,真菌12株占8.11%,以白色念珠菌为主;革兰阴性菌中铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌对青霉素、头孢呋辛、头孢噻肟、头孢哌酮、阿米卡星、妥布霉素等抗菌药物耐药率高,对亚胺培南、美罗培南等抗菌药物较敏感;革兰阳性菌中金黄色葡萄球菌、粪肠球菌及表皮葡萄球菌对红霉素、青霉素及左氧氟沙星等抗菌药物耐药率较高,但对替考拉宁较敏感。结论脑梗死合并褥疮感染的患者病原菌以革兰阴性菌为主,耐药性较强,临床治疗中应以病原菌特点及药敏结果为依据合理应用抗菌药物,以减少新耐药菌株的形成,对褥疮感染的患者进行有针对性的优质护理可以降低医院感染的发生,提高临床疗效。
[Abstract]:Objective to explore the etiology of bedsore infection in patients with cerebral infarction and the effect of nursing intervention. Methods 156 patients with cerebral infarction complicated with bedsore infection from October 2012 to September 2015 were selected to collect the samples from infected sites for culture. Vitek-2Compact type bacteria identification and drug sensitivity analyzer were used to identify and analyze the bacteria. According to the results of drug sensitivity test, the prevention strategy was formulated and targeted treatment was carried out. Results 148 strains of pathogenic bacteria were isolated from the specimens of patients with cerebral infarction and bedsore infection, among which 76 strains of Gram-negative bacteria accounted for 51.35. Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli were used. Acinetobacter baumannii dominated, Gram-positive bacteria accounted for 40.54, Staphylococcus aureus, Enterococcus faecalis, Staphylococcus epidermidis, fungi 12, mainly Candida albicans, Pseudomonas aeruginosa and Klebsiella pneumoniae in Gram-negative bacteria. Escherichia coli has high resistance to penicillin, cefuroxime, cefotaxime, cefoperazone, amikacin and tobramycin, and is more sensitive to imipenem and meropenem. Enterococcus faecalis and Staphylococcus epidermidis were resistant to erythromycin, penicillin and levofloxacin, but sensitive to teicoplanin. Conclusion Gram-negative bacteria are the main pathogens in patients with cerebral infarction and bedsore infection. In order to reduce the formation of new drug-resistant strains, antibiotics should be used rationally according to the characteristics of pathogenic bacteria and the results of drug sensitivity in clinical treatment. The quality nursing of bedsore patients can reduce the incidence of nosocomial infection and improve the clinical efficacy.
【作者单位】：无锡市中西医结合医院急诊室;南京中医药大学护理学院;无锡市中西医结合医院脑外科;
【基金】：江苏省科学基金资助项目(81202958)
【分类号】：R473.74

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