胸腔闭式引流术后院内感染病原菌分布及预防对策研究

发布时间：2018-01-21 12:07

本文关键词： 胸腔闭式引流术院内感染病原菌分布预防对策　出处：《中华医院感染学杂志》2017年21期 　论文类型：期刊论文

【摘要】：目的探究胸腔闭式引流术后院内感染病原菌分布及相应的预防对策,为合理用药提供指导。方法选择2013年5月-2015年5月医院收治的80例行胸腔闭式引流术后发生感染的患者,分析感染患者病原菌分布,观察主要细菌的耐药性,同时总结预防患者感染的护理措施。结果 80例行胸腔闭式引流术后发生感染的患者痰液标本中共分离出病原菌110株,其中革兰阴性菌60株,占54.55%,革兰阳性菌40株,占36.36%,真菌10株,占9.09%;药敏结果显示,肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌、金黄色葡萄球菌及肺炎链球菌对亚胺培南、美罗培南及万古霉素的耐药率为0%,敏感性均较高,其中,肺炎克雷伯菌、大肠埃希菌及鲍氏不动杆菌对哌拉西林、阿莫西林的耐药率均50%,而金黄色葡萄球菌、肺炎链球菌对哌拉西林、阿莫西林、头孢唑林、庆大霉素以及青霉素的耐药性均50%。结论行胸腔闭式引流术后发生感染的患者需合理使用抗菌药物,对行胸腔闭式引流术的患者采取有效的预防护理措施,能够有效降低感染率。
[Abstract]:Objective to investigate the distribution of pathogens of nosocomial infection after thoracic closed drainage and the corresponding preventive measures. Methods from May 2013 to May 2015, 80 patients with infection after closed thoracic drainage were selected, and the distribution of pathogens in infected patients was analyzed. Results 110 strains of pathogenic bacteria were isolated from sputum samples of 80 patients who were infected after thoracic closed drainage. There were 60 Gram-negative bacteria (54.55), 40 Gram-positive bacteria (36.36%), 10 fungi (9.09%). The results showed that Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, Staphylococcus aureus and Streptococcus pneumoniae were resistant to imipenem, meropenem and vancomycin. Among them, Klebsiella pneumoniae, Escherichia coli and Acinetobacter baumannii were resistant to piperacillin and amoxicillin, while Staphylococcus aureus and Streptococcus pneumoniae were resistant to piperacillin and amoxicillin. The drug resistance of cefazolin gentamicin and penicillin were all 50. Conclusion patients with infection after thoracic closed drainage should use antibiotics reasonably. The effective preventive nursing measures for patients undergoing closed thoracic drainage can effectively reduce the infection rate.
【作者单位】：天津医院创伤上肢一病区;
【基金】：国家科技支撑计划基金资助项目(2008BAI52B03)
【分类号】：R446.5
【正文快照】： 胸腔闭式引流是胸外科应用极广的基本手术技术,常规应用于治疗气胸、恶性胸腔积液、脓胸或炎性胸腔积液、创伤性血气胸和胸部手术[1]。有文献报道[2],胸腔闭式引流术治疗自发性气胸治愈率85%左右,是一种令人满意的治疗方法。但是,行胸腔闭式引流术的患者术后时常发生感染,严重

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