急诊ICU患者感染病原菌特点及危险因素分析

发布时间：2018-05-15 14:01

本文选题：急诊ICU患者 + 感染　；参考：《中华医院感染学杂志》2017年19期

【摘要】：目的探讨急诊ICU患者感染病原菌特点及危险因素。方法选取于2015年2月-2016年9月医院ICU内患者180例作为研究对象,对感染患者相应部位取样进行病原学分析和药敏试验,收集患者的临床资料,评估导致感染发生的危险因素。结果 180例患者共出现感染58例,感染率为32.22%,共分离致病菌75株,其中革兰阴性菌31株占41.33%,以大肠埃希菌、肺炎克雷伯菌为主;革兰阳性菌44株占58.67%,以金黄色葡萄球菌、表皮葡萄球菌为主。表皮葡萄球菌对青霉素耐药率75.00%、磺胺甲VA唑耐药率83.33%等具有较强的耐药性,而对替考拉宁、万古霉素等具有较强的敏感性。金黄色葡萄球菌对青霉素耐药率100.00%、阿奇霉素耐药率52.17%等具有较强耐药性,对万古霉素、替考拉宁等具有较强敏感性。革兰阴性菌中大肠埃希菌及肺炎克雷伯菌对头孢唑林耐药率均为100.00%、阿莫西林耐药率均为100.00%等具有较强耐药性,而对头孢哌酮舒巴坦、美罗培南耐等具有较强敏感性。复合外伤、昏迷、格林巴利综合征、重症肌无力、泌尿道插管、动静脉插管、呼吸机使用为导致感染发生的独立危险因素。结论急诊ICU患者院内感染发生率较高,且多为多药耐药菌感染,临床治疗困难性较大,引起感染的危险因素较多,应采取有效措施尽量减少ICU内患者感染的发生。
[Abstract]:Objective to investigate the characteristics and risk factors of infectious pathogens in emergency patients with ICU. Methods from February 2015 to September 2016, 180 patients with ICU in hospital were selected as the study subjects. Pathogenic analysis and drug sensitivity test were performed on the corresponding sites of the infected patients. The clinical data of the patients were collected and the risk factors leading to the infection were evaluated. Results there were 58 cases of infection in 180 patients, the infection rate was 32.22. 75 strains of pathogenic bacteria were isolated, among which 31 strains of Gram-negative bacteria accounted for 41.33%, mainly Escherichia coli and Klebsiella pneumoniae, 44 strains of Gram-positive bacteria accounted for 58.67%, and Staphylococcus aureus was the main bacteria. Staphylococcus epidermidis. Staphylococcus epidermidis had strong resistance to penicillin and sulfamethazol (83.33%), but to teicoplanin and vancomycin. Staphylococcus aureus had strong resistance to penicillin and azithromycin (52.17%) and was sensitive to vancomycin and teicoplanin. Among Gram-negative bacteria, Escherichia coli and Klebsiella pneumoniae had strong resistance to cefazolin and amoxicillin, but were sensitive to cefoperazone sulbactam and meropenem resistance. Compound trauma, coma, Guillain-Barre syndrome, myasthenia gravis, urinary catheterization, arteriovenous intubation, and ventilator use were independent risk factors for infection. Conclusion the incidence of nosocomial infection in emergency patients with ICU is high, and most of them are multidrug resistant bacteria. The clinical treatment is difficult and the risk factors of infection are many. Effective measures should be taken to minimize the incidence of infection in patients with ICU.
【作者单位】：海南医学院附属第二医院急诊科;
【分类号】：R446.5;R459.7

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