心脏术后患者医院感染病原学特点及危险因素分析

发布时间：2018-03-17 13:46

本文选题：手术　切入点：医院感染　出处：《中华医院感染学杂志》2017年19期 　论文类型：期刊论文

【摘要】：目的研究心脏术后医院感染的病原学特点及危险因素。方法回顾性分析2005年1月-2015年12月在医院接受心脏及大血管手术的573例患者,对患者术后医院感染病原学特点及危险因素进行统计分析。结果患者发生院内感染例数为74例,感染率为12.91%,其中呼吸道感染最为常见。共检测出病原菌158株,其中革兰阴性菌为80株占50.63%,革兰阳性菌为48占30.38%,真菌30株占18.99%。革兰阳性菌对红霉素、青霉素、庆大霉素等药物耐药性较高,其中青霉素、庆大霉素耐药率为100%,对利奈唑胺、替考拉宁及万古霉素高度敏感,耐药率为0。革兰阴性菌对头孢丙烯、阿米卡星、头孢呋辛等药物耐药率较高,对美罗培南、亚胺培南及环丙沙星有很高的敏感,有些耐药率为0。通过对感染因素分析,患者的年龄、糖尿病、手术时间、术后二次手术、呼吸机使用时间、深静脉留置时间、导尿管留置时间、术后24h输血浆量、术后24h输少浆血量等因素差异,是引发患者出现院内感染的危险因素(P0.05)。结论医院应针对危险因素及患者病原学特点制定针对性的防控措施,促进患者预后。
[Abstract]:Objective to study the etiological characteristics and risk factors of nosocomial infection after cardiac surgery. The etiological characteristics and risk factors of postoperative nosocomial infection were statistically analyzed. Results there were 74 cases of nosocomial infection, the infection rate was 12.91%, and respiratory tract infection was the most common. 158 strains of pathogenic bacteria were detected. Among them, 80 Gram-negative bacteria accounted for 50.63, 48 Gram-positive bacteria accounted for 30.38 and 30 fungi accounted for 18.99.The Gram-positive bacteria were highly resistant to erythromycin, penicillin and gentamicin, among which penicillin and gentamicin resistance rates were 100%, and were resistant to linazolamine. Teicoplanin and vancomycin were highly sensitive, and the resistance rate of Gram-negative bacteria was 0.The resistance rates of Gram-negative bacteria to cefpropene, amikacin and cefuroxime were higher, and highly sensitive to meropenem, imipenem and ciprofloxacin. By analyzing the infection factors, the patient's age, diabetes, operative time, postoperative secondary operation, ventilator time, deep vein indwelling time, catheter indwelling time, 24 hours after operation, The difference of blood volume at 24 hours after operation is the risk factor of nosocomial infection. Conclusion the hospital should make preventive and control measures according to the risk factors and etiological characteristics of the patients to promote the prognosis of the patients.
【作者单位】：宁波市医疗中心李惠利医院心脏监护病房;
【分类号】：R654.2

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