重症监护病房血管导管相关感染目标性监测和抗菌治疗分析

发布时间：2018-02-20 02:29

本文关键词： 重症监护病房血管导管目标性监测抗菌药物治疗　出处：《中华医院感染学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探讨重症监护病房(ICU)血管导管相关感染发生情况、影响因素、病原菌分布及抗菌治疗方式等,为相关临床研究提供参考依据。方法选取2014年1月-2015年10月医院ICU临床收治的重症患者252例为研究对象,针对患者的感染情况、导致感染的影响因素、感染的病原菌分布、药敏试验结果及抗菌治疗效果进行调查研究。结果 ICU 252例患者中,发生血管导管感染44例,感染率为17.46%;年龄、格拉斯哥昏迷评分、住院时间、合并症种类、昏迷时间和感染史等因素是导致患者感染的影响因素;感染患者共检测出病原菌51株,其中革兰阴性菌36株占70.59%,革兰阳性菌11株占21.57%,真菌4株占7.84%;检出的主要革兰阴性菌对左氧氟沙星、氨苄西林的耐药率为100.00%,对哌拉西林、他唑巴坦的耐药率为0,检出的主要革兰阳性菌对左氧氟沙星、庆大霉素的耐药率为100.00%,对利福平、万古霉素的耐药率为0。结论 ICU血管导管相关感染情况较为严重,年龄、格拉斯哥昏迷评分、住院时间、合并症种类、昏迷时间和感染史等因素是导致患者感染的影响因素,在临床治疗过程中应根据患者的药敏试验结果实施针对性的治疗,可以显著提升临床综合疗效。
[Abstract]:Objective to investigate the incidence, influencing factors, distribution of pathogenic bacteria and antimicrobial treatment of ICU in intensive care unit (ICU). Methods from January 2014 to October 2015, a total of 252 severe cases of ICU patients were selected as the study objects. The infection status of the patients, the influencing factors of infection, and the distribution of pathogenic bacteria were analyzed. Results the results of drug sensitivity test and antimicrobial therapy were investigated. Results among the 252 patients with ICU, 44 cases had vascular duct infection, the infection rate was 17.46%, age, Glasgow coma score, length of stay in hospital, types of complications, The duration of coma and history of infection were the influencing factors of infection, 51 strains of pathogenic bacteria were detected in infected patients. Among them 36 Gram-negative bacteria accounted for 70.59um, 11 Gram-positive bacteria accounted for 21.57 and 4 fungi accounted for 7.845.The resistant rate of the main gram-negative bacteria to levofloxacin and ampicillin was 100.00. The drug resistance rate of tazobactam was 0. The resistant rate of the main gram-positive bacteria to levofloxacin and gentamycin was 100.00. to rifampicin, vancomycin was 0.Conclusion the ICU vascular catheter-related infection is more serious. Glasgow coma score, length of stay in hospital, type of complications, duration of coma and history of infection were the influential factors of infection. In the course of clinical treatment, targeted treatment should be carried out according to the results of drug sensitivity test. It can significantly improve the comprehensive clinical efficacy.
【作者单位】：安阳市第六人民医院护理部;安阳市第六人民医院感染管理科;安阳市第六人民医院ICU;安阳市第六人民医院CCU;
【分类号】：R459.7

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