开胸术后合并胸腔感染患者的病原菌分布与耐药性及相关因素分析

发布时间：2018-03-19 08:57

本文选题：开胸手术　切入点：胸腔感染　出处：《中华医院感染学杂志》2017年23期 　论文类型：期刊论文

【摘要】：目的分析开胸术后合并胸腔感染患者的病原菌分布、耐药性及相关因素,为医院感染的预防和控制工作提供客观依据。方法选取2009年1月-2016年12月于医院接受开胸手术的616例患者作为研究对象;观察分析患者术后胸腔感染的发生率,对发生胸腔感染患者的引流液体或胸水标本中的病原菌分布及耐药性进行检测和分析,对与开胸手术合并胸腔感染发生相关的危险因素进行分析。结果 616例患者中有80例患者发生术后胸腔感染,感染率为13.0%,在感染患者的标本共检出病原菌80株,以革兰阴性菌为主,共52株占65.0%;革兰阴性菌对头孢他啶、头孢噻肟、头孢吡肟、左氧氟沙星的耐药率较高;Logistic多元回归分析结果显示,开胸手术合并胸腔感染的发生与手术时间、留置引流管时间、术前肺功能、术后创口污染具有相关性(P0.05)。结论开胸手术合并胸腔感染的病原菌分布、耐药性及相关因素均具有一定的特征,临床医生应对其给予高度重视和密切监测,及时采取干预措施并选取敏感性抗菌药物进行治疗,以达到提高医院感染预防和控制效果、减少病原菌耐药的目的。
[Abstract]:Objective to analyze the distribution of pathogens, drug resistance and related factors in patients with thoracic infection after thoracotomy. Methods from January 2009 to December 2016, 616 patients undergoing thoracotomy in hospital were selected as study subjects, and the incidence of thoracic infection after operation was observed and analyzed. The distribution and drug resistance of pathogenic bacteria in drainage fluid or pleural effusion of patients with pleural infection were detected and analyzed. Results 80 out of 616 patients had postoperative thoracic infection, and the infection rate was 13.0. A total of 80 strains of pathogenic bacteria were detected in the specimens of infected patients. 52 strains of Gram-negative bacteria accounted for 65.0.The drug resistance rate of Gram-negative bacteria to ceftazidime, cefotaxime, cefepime and levofloxacin was higher. Logistic multiple regression analysis showed that the incidence and time of thoracotomy combined with thoracic infection were higher. The time of indwelling drainage tube, preoperative pulmonary function and postoperative wound contamination were correlated with P0.05.Conclusion the distribution of pathogens, drug resistance and related factors in thoracotomy combined with thoracic infection have some characteristics. Clinicians should pay close attention to it and take intervention measures and select sensitive antibiotics for treatment in order to improve the effect of prevention and control of nosocomial infection and reduce the drug resistance of pathogenic bacteria.
【作者单位】：连云港市第一人民医院胸外科;
【基金】：江苏省科学计划研究基金资助项目(20150138)
【分类号】：R561;R655

【相似文献】