發(fā)布時間：2018-03-17 13:46

  本文選題：手術(shù)　切入點(diǎn)：醫(yī)院感染　出處：《中華醫(yī)院感染學(xué)雜志》2017年19期 　論文類型：期刊論文

【摘要】：目的研究心臟術(shù)后醫(yī)院感染的病原學(xué)特點(diǎn)及危險因素。方法回顧性分析2005年1月-2015年12月在醫(yī)院接受心臟及大血管手術(shù)的573例患者,對患者術(shù)后醫(yī)院感染病原學(xué)特點(diǎn)及危險因素進(jìn)行統(tǒng)計分析。結(jié)果患者發(fā)生院內(nèi)感染例數(shù)為74例,感染率為12.91%,其中呼吸道感染最為常見。共檢測出病原菌158株,其中革蘭陰性菌為80株占50.63%,革蘭陽性菌為48占30.38%,真菌30株占18.99%。革蘭陽性菌對紅霉素、青霉素、慶大霉素等藥物耐藥性較高,其中青霉素、慶大霉素耐藥率為100%,對利奈唑胺、替考拉寧及萬古霉素高度敏感,耐藥率為0。革蘭陰性菌對頭孢丙烯、阿米卡星、頭孢呋辛等藥物耐藥率較高,對美羅培南、亞胺培南及環(huán)丙沙星有很高的敏感,有些耐藥率為0。通過對感染因素分析,患者的年齡、糖尿病、手術(shù)時間、術(shù)后二次手術(shù)、呼吸機(jī)使用時間、深靜脈留置時間、導(dǎo)尿管留置時間、術(shù)后24h輸血漿量、術(shù)后24h輸少漿血量等因素差異,是引發(fā)患者出現(xiàn)院內(nèi)感染的危險因素(P0.05)。結(jié)論醫(yī)院應(yīng)針對危險因素及患者病原學(xué)特點(diǎn)制定針對性的防控措施,促進(jìn)患者預(yù)后。
[Abstract]:Objective to study the etiological characteristics and risk factors of nosocomial infection after cardiac surgery. The etiological characteristics and risk factors of postoperative nosocomial infection were statistically analyzed. Results there were 74 cases of nosocomial infection, the infection rate was 12.91%, and respiratory tract infection was the most common. 158 strains of pathogenic bacteria were detected. Among them, 80 Gram-negative bacteria accounted for 50.63, 48 Gram-positive bacteria accounted for 30.38 and 30 fungi accounted for 18.99.The Gram-positive bacteria were highly resistant to erythromycin, penicillin and gentamicin, among which penicillin and gentamicin resistance rates were 100%, and were resistant to linazolamine. Teicoplanin and vancomycin were highly sensitive, and the resistance rate of Gram-negative bacteria was 0.The resistance rates of Gram-negative bacteria to cefpropene, amikacin and cefuroxime were higher, and highly sensitive to meropenem, imipenem and ciprofloxacin. By analyzing the infection factors, the patient's age, diabetes, operative time, postoperative secondary operation, ventilator time, deep vein indwelling time, catheter indwelling time, 24 hours after operation, The difference of blood volume at 24 hours after operation is the risk factor of nosocomial infection. Conclusion the hospital should make preventive and control measures according to the risk factors and etiological characteristics of the patients to promote the prognosis of the patients.
【作者單位】： 寧波市醫(yī)療中心李惠利醫(yī)院心臟監(jiān)護(hù)病房;
【分類號】：R654.2

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本文編號：1625006