上消化道出血患者医院感染的病原菌分布与预防

发布时间：2018-03-20 11:03

本文选题：上消化道出血　切入点：医院感染　出处：《中华医院感染学杂志》2016年13期 　论文类型：期刊论文

【摘要】：目的探讨上消化道出血患者医院感染的病原菌分布特点及相关危险因素,以降低医院感染。方法选择2012年4月-2015年6月因上消化道出血入院接受住院治疗320例患者为研究对象,对医院感染的患者进行痰培养,分析病原菌分布及相关危险因素,并提出相关预防措施。结果 320例上消化道出血患者发生医院感染72例,感染率为22.50%;感染部位主要分布于上呼吸道、下呼吸道、腹腔,分别占22.22%、31.94%、15.28%;共培养出病原菌82株,主要病原菌为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌,分别占24.39%、18.29%、21.95%;多因素Logistic回归结果表明高龄、住院天数、ECOG评分、抗菌药物使用及侵入性操作等是上消化道出血患者医院感染的危险因素。结论上消化道出血患者医院感染以大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌等病原菌为主,对相关危险因素应采取抗感染措施,改善患者预后。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and related risk factors of nosocomial infection in patients with upper gastrointestinal hemorrhage and to reduce nosocomial infection. Methods 320 patients who were admitted to hospital for upper gastrointestinal bleeding from April 2012 to June 2015 were selected as study objects. Sputum culture was carried out in patients with nosocomial infection, distribution of pathogenic bacteria and related risk factors were analyzed, and relevant preventive measures were put forward. Results 72 cases of nosocomial infection occurred in 320 patients with upper gastrointestinal bleeding. The infection rate was 22.50. The infection site was mainly distributed in upper respiratory tract, lower respiratory tract and abdominal cavity, accounting for 22.22%, 31.94 and 15.28%, respectively. 82 strains of pathogenic bacteria were cultured, the main pathogens were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and the main pathogens were Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus. The results of multivariate Logistic regression showed that the age, the length of stay in hospital and the score of ECOG were significant. The use of antimicrobial agents and invasive operation are the risk factors of nosocomial infection in patients with upper gastrointestinal bleeding. Conclusion the nosocomial infections of upper gastrointestinal bleeding patients are mainly caused by Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae and so on. Anti-infection measures should be taken to improve the prognosis of patients with related risk factors.
【作者单位】：南阳市中心医院消化内科;南阳医学高等专科学校第一附属医院麻醉手术科;
【基金】：河南省科技攻关基金资助项目(2000125748)
【分类号】：R573.2

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