开放性骨折患者发生医院感染病原学特征与危险因素分析

发布时间：2018-04-01 03:08

本文选题：开放性骨折　切入点：医院感染　出处：《中华医院感染学杂志》2017年19期

【摘要】：目的分析开放性骨折患者发生医院感染的细菌种类、耐药性及危险因素,为今后临床制定预防措施和合理用药提供科学依据。方法选取医院2013年3月-2016年12月间收治的开放性骨折患者980例作为研究对象,对出现院内感染患者的临床资料进行回顾性分析,研究其感染部位、病原菌类型、耐药性及危险因素。结果 980例开放性骨折患者中共有51例出现院内感染,感染率5.20%,发生感染的主要部位为呼吸道感染、骨髓炎及泌尿系统感染;共分离出64株病原菌,其中革兰阴性菌39株占60.94%;革兰阳性菌22例占34.38%;真菌3例占4.69%;根据药敏试验结果,多数革兰阴性菌对青霉素、多西环素和磺胺类抗菌药物耐药率均80%,对氨基糖苷类及碳青霉稀类敏感性较高;而多数革兰阳性菌对青霉素类、头孢类及喹诺酮类耐药率均65%,对万古霉素敏感性较高。年龄≥60岁、损伤程度Ⅲ级、合并糖尿病等基础疾病、卧床时间≥5d均为开放性骨折的独立危险因素(P0.05)。结论通过分析开放性骨折发生医院感染的病原学特征、耐药性及危险因素,为外科指导抗菌药物应用提供科学依据,为医院开展感染防治措施提供理论支持。
[Abstract]:Objective to analyze the patients with open fracture occurred in bacteria of nosocomial infection, drug resistance and risk factors, to provide scientific basis for prevention and rational use of drugs for future clinical methods. Open hospital in March 2013 -2016 year in December from fracture patients 980 cases as the research object, the clinical data of patients with nosocomial infection were retrospectively study on the analysis of the site of infection, pathogenic bacteria, drug resistance and risk factors. Results 980 cases of open fracture patients nosocomial infection occurred in 51 cases, the infection rate was 5.20%, the main part of infection for respiratory tract infection, urinary system infection and osteomyelitis; a total of 64 strains of pathogenic bacteria were isolated, gram negative 39 strains of gram positive bacteria accounted for 60.94%; 22 cases accounted for 34.38%; 3 cases of fungi accounted for 4.69%; according to the results of drug sensitivity test, most of gram negative bacteria to penicillin, doxycycline and sulfonamides The resistance rate of 80% compounds, aminoglycoside and carbapenems sensitive; while the majority of gram positive bacteria to penicillins, cephalosporins and quinolones resistance rate of 65%, higher sensitivity to vancomycin. 60 years of age or older, the degree of injury grade, diabetes and other basic diseases were more than 5D in bed time independent risk factors for open fractures (P0.05). Conclusion: through the analysis of open fracture of the hospital infection pathogens, drug resistance and risk factors, to provide scientific basis for surgical guidance of the application of antibiotics, infection prevention and control measures to provide theoretical support for the hospital.

【作者单位】：中国人民武装警察部队海南边防总队医院骨科;台州市第一人民医院骨科;
【分类号】：R446.5;R683

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