重症肝病患者腹水感染的调查与危险因素分析

发布时间：2018-03-16 16:28

本文选题：重症肝病　切入点：腹水　出处：《中华医院感染学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的了解重症肝病患者发生腹水感染的病原菌构成与分布,分析重症肝病并腹水感染的临床特点,探讨重症肝病患者入院后诱发腹水感染的危险因素,为制定有效的院内腹水感染的预防控制措施提供可信依据。方法对2015-2016年医院重症肝病发生腹水感染患者送检的腹水标本,分离培养的病原菌及药物敏感测定数据进行回顾性调查,进行菌种鉴定及统计分析。结果 147例重症肝病患者发生腹水感染44例,感染率29.9%;感染患者分离病原菌44株,以革兰阳性菌为主占56.8%,革兰阴性菌占40.9%,真菌占2.3%,排前5位分别为表皮葡萄球菌、溶血葡萄球菌、粪肠球菌、肺炎克雷伯菌、大肠埃希菌;葡萄球菌属对环丙沙星、头孢哌酮、头孢曲松和头孢呋肟的耐药率50.0%,肠球菌属对头孢噻吩、头孢吡肟、头孢唑林、头孢他啶和头孢曲松的耐药率50.0%,肺炎克雷伯菌对氨苄西林、头孢噻吩、头孢吡肟、头孢哌酮与青霉素的耐药率50.0%,大肠埃希菌对头孢噻吩与环丙沙星的耐药率50.0%;基础疾病、肝功能状态、住院时间、侵入性操作、抗菌药物使用等是腹水感染的危险因素。结论重症肝病患者腹水感染的危险度较高,葡萄球菌属为感染的主要病原菌,且呈现耐药性较高的特点,加强医院感染管理,减少手术时间与合理用药是降低腹水感染的有效方法。
[Abstract]:Objective to investigate the pathogenic bacteria composition and distribution of ascites infection in patients with severe liver disease, to analyze the clinical characteristics of severe liver diseases with ascites infection, and to explore the risk factors of ascites infection after admission in patients with severe liver diseases. To provide reliable basis for effective prevention and control measures of nosocomial ascites infection. Methods the ascites samples from patients with ascites infection in severe liver diseases in hospitals from 2015 to 2016 were examined. Results 44 cases of ascites infection occurred in 147 patients with severe liver disease, and the infection rate was 29.9%. 44 strains of pathogenic bacteria were isolated from infected patients. Gram-positive bacteria accounted for 56.8%, Gram-negative bacteria 40.9 and fungi 2.3. The top 5 were Staphylococcus epidermidis, Staphylococcus haemolyticus, Enterococcus faecalis, Klebsiella pneumoniae, Escherichia coli. The resistance rate of Enterococcus to cefthiophene, cefepime, cefazolin, ceftazidime and ceftriaxone was 50.0. Klebsiella pneumoniae was resistant to ampicillin, cefthiophene, cefepime. The drug resistance rate of cefoperazone and penicillin was 50.0 and that of Escherichia coli to cefthiophene and ciprofloxacin was 50.0. Conclusion the risk of ascites infection in patients with severe liver disease is higher. Staphylococcus is the main pathogen of infection, and has the characteristics of high drug resistance, strengthening the management of hospital infection. Reducing operative time and rational use of drugs is an effective method to reduce ascites infection.
【作者单位】：青岛市市立医院感染管理科;青岛大学附属医院消化内科;青岛市市立医院门诊部;
【基金】：国家自然科学基金资助项目(81572320)
【分类号】：R575

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