医院相关性感染性心内膜炎的影响因素分析及预防对策研究

发布时间：2018-02-24 05:32

本文关键词： 医院相关性感染性心内膜炎影响因素预防对策　出处：《中华医院感染学杂志》2017年17期 　论文类型：期刊论文

【摘要】：目的探讨医院相关性感染性心内膜炎的影响因素及预防对策,以降低医院相关性感染性心内膜炎感染率。方法选择2007年1月-2015年1月在医院接受治疗的229例医院相关性感染性心内膜炎患者,采集患者血液标本进行细菌培养、鉴定及药敏试验,并对医院相关性感染性心内膜炎的影响因素进行统计分析。结果共送检标本229份,其中阳性标本163份,阳性率为71.18%;共分离出病原菌273株,其中革兰阳性菌185株占67.76%,革兰阴性菌74株占27.11%,真菌14株占5.13%;主要革兰阳性菌对青霉素、环丙沙星耐药率均50%,而对利奈唑胺、替考拉宁非常敏感;主要革兰阴性菌对庆大霉素具有较高的耐药率,均50%;而对亚胺培南、美罗培南非常敏感,耐药率均12%;大肠埃希菌及嗜麦芽寡养单胞菌对阿米卡星的耐药率均12%;相关因素分析结果显示,年龄、广谱抗菌药物使用、风湿性瓣膜心脏病、先天性心脏病、非风湿性瓣膜心脏病、缺血性心脏病、心外科手术、血液透析是医院相关性感染性心内膜炎的影响因素(P0.05)。结论医院相关性感染性心内膜炎的影响因素为年龄、广谱抗菌药物使用、风湿性瓣膜心脏病、先天性心脏病、非风湿性瓣膜心脏病、缺血性心脏病、心外科手术、血液透析,临床应根据影响因素采取相应的预防措施,以降低医院相关性感染性心内膜炎的发生率。
[Abstract]:Objective to explore the influencing factors and preventive measures of nosocomial infectious endocarditis. Methods from January 2007 to January 2015, 229 patients with nosocomial infective endocarditis were selected and their blood samples were collected for bacterial culture. Results 229 samples were collected, 163 of them were positive, and the positive rate was 71.18.The pathogenic bacteria 273 strains were isolated. Among them 185 Gram-positive bacteria accounted for 67.76um, 74 Gram-negative bacteria accounted for 27.11 and 14 fungi accounted for 5.13.The main Gram-positive bacteria were resistant to penicillin and ciprofloxacin, and were sensitive to linazolamine and teicoplanin. The main gram-negative bacteria showed high resistance to gentamicin (50%), and were sensitive to imipenem and meropenem. The drug resistance rates of Escherichia coli and Amikacin were 12. The related factor analysis showed that age, use of broad-spectrum antimicrobial agents, rheumatic valve heart disease, congenital heart disease, Non-rheumatic valvular heart disease, ischemic heart disease, cardiac surgery and hemodialysis are the influencing factors of nosocomial infectious endocarditis. Conclusion the influencing factors of nosocomial infective endocarditis are age. The use of broad-spectrum antimicrobial drugs, rheumatic valve heart disease, congenital heart disease, non-rheumatic valve heart disease, ischemic heart disease, cardiac surgery, hemodialysis, clinical should take appropriate preventive measures according to the influencing factors. To reduce the incidence of nosocomial infectious endocarditis.
【作者单位】：衢州市人民医院感染科;
【基金】：衢州市科技计划项目医疗卫生基金资助项目(20130633B11)
【分类号】：R542.4

【相似文献】