手术部位感染与手卫生相关性研究

发布时间：2019-06-25 17:19

【摘要】：目的探讨外科手术部位感染的发生率、常见致病菌谱及其耐药性,并分析手术部位感染发生率与手卫生产品消耗量之间的统计学相关性。方法回顾性分析2015年南京鼓楼医院与南京军区南京总医院诊治的外科手术病人资料,遴选出发生手术部位感染的研究人群,分析并总结其手术部位感染相关资料,并针对各科室手术部位感染发生率与该科室手卫生产品消耗量进行相关性分析及多元回归分析。结果在30 678例外科手术中,共307例发生手术部位感染,总体发生率为1.00%;不同科室的手术部位感染发生率存在较大差异,以普通外科最高(2.14%)、神经外科最低(0.14%);手术部位感染常见致病菌包括大肠埃希菌(35.8%)、金黄色葡萄球菌(13.20%)、粪肠球菌(7.84%)、铜绿假单胞菌(5.89%)、肺炎克雷伯菌(4.90%)等。相应病原菌的耐药率存在较大差异。外科各科室的手术部位感染发生率与三种手卫生产品消耗量均呈显著负相关(r=-0.83~-0.88、P=0.0031~0.0083);多元回归分析进一步显示:免洗手消毒液使用量显著影响手术部位感染发生率(P=0.023)。结论手卫生是影响手术部位感染发生率的关键因素,推动医务人员手卫生依从性或有助于减少手术部位感染。了解手术部位感染临床特征有助于制定个体化、区域性手术部位感染防治策略。
[Abstract]:Objective to investigate the incidence of surgical site infection, common pathogenic bacteria spectrum and drug resistance, and to analyze the statistical correlation between the incidence of surgical site infection and the consumption of hand hygiene products. Methods the data of surgical patients diagnosed and treated in Nanjing Gulou Hospital and Nanjing General Hospital of Nanjing military region in 2015 were analyzed retrospectively. the research population with surgical site infection was selected, the related data of surgical site infection were analyzed and summarized, and the correlation analysis and multiple regression analysis were carried out between the incidence of surgical site infection and the consumption of hand hygiene products in each department. Results in 30678 cases, 307 cases had surgical site infection, the overall incidence was 1.00%, the incidence of surgical site infection in different departments was the highest (2.14%) and neurosurgery was the lowest (0.14%), and the incidence of surgical site infection was the highest in different departments (2.14%) and the lowest in neurosurgery (0.14%). The common pathogens of surgical site infection included Escherichia coli (35.8%), Staphylococcus aureus (13.20%), Enterococcus faecalis (7.84%), Pseudomonas aeruginosa (5.89%) and Klebsiella pneumoniae (4.90%). There are great differences in the drug resistance rate of the corresponding pathogens. There was a significant negative correlation between the incidence of surgical site infection and the consumption of three hand hygiene products (r 鈮，

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