住院患者医院感染病原菌耐药性与影响因素分析

Risk factors and drug resistance of pathogens for nosocomial infection in inpatients

    摘要
  • 摘要: 目的 探讨住院患者医院感染病原菌耐药情况与感染的影响因素,了解住院患者医院感染的影响因素及病原菌耐药性。方法 采用查阅病例的方法,随机抽取2017年1-6月内蒙古自治区人民医院5 000例住院患者的临床资料进行回顾性调查,分析患者性别、年龄、住院时间、侵入性操作和免疫抑制剂使用情况等信息,归纳住院患者医院感染的影响因素。结果 5 000例住院患者发生医院感染367例,感染率为7.34%,医院感染614例次,例次感染率为12.28%。感染部位以下呼吸道、泌尿道、血流感染为主。共培养分离病原菌551株,其中革兰阴性菌353株占64.07%,以大肠埃希菌、铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌为主;革兰阳性菌120株占21.78%,以屎肠球菌、金黄色葡萄球菌和粪肠球菌为主;真菌64株占11.62%,以白假丝酵母为主。大肠埃希菌对丁胺卡那霉素、呋喃妥因、美罗培南、哌拉西林/他唑巴坦、头孢替坦和亚胺培南较敏感;铜绿假单胞菌对丁胺卡那霉素和妥布霉素较敏感;鲍氏不动杆菌对抗菌药物耐药率均>70%;肺炎克雷伯菌对丁胺卡那霉素、美罗培南、哌拉西林/他唑巴坦、头孢他啶、头孢替坦和亚胺培南较敏感;屎肠球菌对替加环素、万古霉素和利奈唑胺较敏感。年龄、住院时间、侵入性操作、抗菌药物使用、昏迷、合并糖尿病是住院患者发生医院感染的影响因素(P＜0.001)。结论 评估患者医院感染风险,采取针对性的预防与控制措施,可有效降低医院感染风险。

     

    Abstract: OBJECTIVE To discuss and understand the drug resistance of pathogens of nosocomial infection in inpatients and the risk factors of nosocomial infection.METHODS The clinical data of 5 000 inpatients in Inner Mongolia People’s Hospital during Jan. to Jun. 2017 which were randomized selected were retrospectively analyzed by means of case review. The gender, age, length of stay, invasive operation and use of immunosuppression of the patients were analyzed to figure out the risk factors of nosocomial infection in inpatients.RESULTS Among the 5 000 inpatients in this study, there were 347 cases of nosocomial infection, with an infection rate of 7.34%. The number of nosocomial infection cases was 614, and the case number infection rate was 12.28%. The major infection sites were lower respiratory tract, urinary tract, and blood infection. A total of 551 strains of pathogens were detected, including 353 strains of Gram-negative bacteria（64.07%） which were dominated by Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumonia, 120 strains of Gram-positive bacteria（21.78%） which were dominated by Enterococcus faecalis, Staphylococcus aureus and Enterococcus faecali, and 64 strains of fungi（11.62%） which were dominated by Candida albicans. E. coli strains were sensitive to amikacin, macrodantin, meropenem, piperacillin tazobatam, cefotetan, imipenem; P. aeruginosa strains were sensitive to amikanamycin and tobramycin; the drug resistance rates of A. baumanii were above 70% to all antibiotics; K. pneumoniae strains were sensitive to amikacin, meropenem, piperacillin tazobatam, deftazidime, cefotetan and imipenem; E. faecium strains were sensitive to tigecycline, vancomycin and linezolid. Age, length of stay, invasive operation, antibiotics use, coma, and diabetes were found as the risk factors of nosocomial infection in inpatients（P＜0.001）.CONCLUSION Evaluation of the infection risk of the patients and taking targeted prevention and control interventions could effectively reduce the risk of nosocomial infection.

     

    • HTML全文
    • 参考文献(0)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回
下载中心