本文選題：急診ICU患者 + 感染�。� 參考：《中華醫(yī)院感染學(xué)雜志》2017年19期

【摘要】：目的探討急診ICU患者感染病原菌特點及危險因素。方法選取于2015年2月-2016年9月醫(yī)院ICU內(nèi)患者180例作為研究對象,對感染患者相應(yīng)部位取樣進行病原學(xué)分析和藥敏試驗,收集患者的臨床資料,評估導(dǎo)致感染發(fā)生的危險因素。結(jié)果 180例患者共出現(xiàn)感染58例,感染率為32.22%,共分離致病菌75株,其中革蘭陰性菌31株占41.33%,以大腸埃希菌、肺炎克雷伯菌為主;革蘭陽性菌44株占58.67%,以金黃色葡萄球菌、表皮葡萄球菌為主。表皮葡萄球菌對青霉素耐藥率75.00%、磺胺甲VA唑耐藥率83.33%等具有較強的耐藥性,而對替考拉寧、萬古霉素等具有較強的敏感性。金黃色葡萄球菌對青霉素耐藥率100.00%、阿奇霉素耐藥率52.17%等具有較強耐藥性,對萬古霉素、替考拉寧等具有較強敏感性。革蘭陰性菌中大腸埃希菌及肺炎克雷伯菌對頭孢唑林耐藥率均為100.00%、阿莫西林耐藥率均為100.00%等具有較強耐藥性,而對頭孢哌酮舒巴坦、美羅培南耐等具有較強敏感性。復(fù)合外傷、昏迷、格林巴利綜合征、重癥肌無力、泌尿道插管、動靜脈插管、呼吸機使用為導(dǎo)致感染發(fā)生的獨立危險因素。結(jié)論急診ICU患者院內(nèi)感染發(fā)生率較高,且多為多藥耐藥菌感染,臨床治療困難性較大,引起感染的危險因素較多,應(yīng)采取有效措施盡量減少ICU內(nèi)患者感染的發(fā)生。
[Abstract]:Objective to investigate the characteristics and risk factors of infectious pathogens in emergency patients with ICU. Methods from February 2015 to September 2016, 180 patients with ICU in hospital were selected as the study subjects. Pathogenic analysis and drug sensitivity test were performed on the corresponding sites of the infected patients. The clinical data of the patients were collected and the risk factors leading to the infection were evaluated. Results there were 58 cases of infection in 180 patients, the infection rate was 32.22. 75 strains of pathogenic bacteria were isolated, among which 31 strains of Gram-negative bacteria accounted for 41.33%, mainly Escherichia coli and Klebsiella pneumoniae, 44 strains of Gram-positive bacteria accounted for 58.67%, and Staphylococcus aureus was the main bacteria. Staphylococcus epidermidis. Staphylococcus epidermidis had strong resistance to penicillin and sulfamethazol (83.33%), but to teicoplanin and vancomycin. Staphylococcus aureus had strong resistance to penicillin and azithromycin (52.17%) and was sensitive to vancomycin and teicoplanin. Among Gram-negative bacteria, Escherichia coli and Klebsiella pneumoniae had strong resistance to cefazolin and amoxicillin, but were sensitive to cefoperazone sulbactam and meropenem resistance. Compound trauma, coma, Guillain-Barre syndrome, myasthenia gravis, urinary catheterization, arteriovenous intubation, and ventilator use were independent risk factors for infection. Conclusion the incidence of nosocomial infection in emergency patients with ICU is high, and most of them are multidrug resistant bacteria. The clinical treatment is difficult and the risk factors of infection are many. Effective measures should be taken to minimize the incidence of infection in patients with ICU.
【作者單位】： 海南醫(yī)學(xué)院附屬第二醫(yī)院急診科;
【分類號】：R446.5;R459.7

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