内科住院患者医院感染病原菌分布与危险因素分析

发布时间：2018-10-12 15:19

【摘要】：目的探讨医院内科住院患者医院感染的病原菌分布、耐药性及感染危险因素,为指导临床患者抗菌药物的使用、降低医院感染率提供依据。方法回顾性分析2013年7月-2014年6月医院内科住院感染患者临床资料,针对患者阳性标本采用BACTEC9000培养系统分离培养,药敏试验采用NCCLS指定的K-B琼脂法进行,数据采用SPSS18.0软件进行统计分析。结果 12 755例内科住院患者发生医院感染304例、425例次,医院感染率为2.38%、例次感染率3.33%;医院感染科室排前3位的是ICU、神经内科和呼吸内科,分别占28.94%、16.00%和11.76%;感染部位以下呼吸道、上呼吸道及泌尿系感染为主,分别占33.41%、21.88%和15.29%;共分离出病原菌194株,其中革兰阳性菌35株占18.04%,革兰阴性菌126株占64.95%;检出多药耐药菌46株,检出率为23.71%;主要革兰阳性菌对青霉素G、左氧氟沙星和庆大霉素的耐药率均较高,均69.00%,主要革兰阴性菌对阿米卡星、美罗培南、头孢哌酮/舒巴坦、亚胺培南和妥布霉素的耐药率均较其他抗菌药物低,均60.00%;住院天数、泌尿道插管次数、合并糖尿病、使用抗菌药物是内科住院患者医院感染的高危因素。结论内科住院患者的感染因素较为复杂,临床应针对危险因素采取防护措施,控制医院感染的发生。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria, drug resistance and risk factors of nosocomial infection in hospitalized patients in order to guide the use of antimicrobial agents in clinical patients and to reduce the nosocomial infection rate. Methods the clinical data of inpatients with infection in hospital from July 2013 to June 2014 were retrospectively analyzed. The positive specimens were isolated and cultured by BACTEC9000 culture system. The drug sensitivity test was performed by K-B Agar method designated by NCCLS. The data were analyzed by SPSS18.0 software. Results among 12 755 inpatients, 304 were nosocomial infection, 425 were nosocomial infection, the nosocomial infection rate was 2.38 and the nosocomial infection rate was 3.33.The top 3 of the nosocomial infection departments were ICU, neurology department and respiratory department, accounting for 28.9416.00% and 11.76%, respectively. 194 strains of pathogenic bacteria were isolated, of which 35 strains were Gram-positive bacteria (18.04%), 126 strains were Gram-negative bacteria (64.95%), 46 strains of multidrug resistant bacteria (MDR) were detected. The positive rate of main gram-positive bacteria to penicillin G, levofloxacin and gentamicin was higher, all of them were 69.00. The main gram-negative bacteria were resistant to amikacin, meropenem, cefoperazone / sulbactam. The drug resistance rates of imipenem and tobramycin were lower than those of other antimicrobial agents, and the hospital stay days, urinary catheterization times, diabetes mellitus and antibiotic use were the high risk factors of nosocomial infection. Conclusion the infection factors of inpatients in internal medicine are complicated, and the prevention measures should be taken to control the nosocomial infection.
【作者单位】：新疆生产建设兵团医院石河子大学医学院第二附属医院院感办;
【基金】：新疆生产建设兵团卫生科技计划基金资助项目(兵卫发[2013]32)
【分类号】：R446.5

【相似文献】