住院患者医院感染临床及病原学结果调查分析

Clinical and etiologic survey on nosocomial infections of inpatients

目的探讨综合性医院住院患者医院感染的临床特点,以采取相关的有效防治措施。方法采用前瞻性和回顾性结合的调查方法,对我院93680例住院患者的临床资料进行分析,细菌鉴定采用荷兰Organon Teknika公司生产的BarcT/Aiert 240系统检测仪及其配套的成人需氧瓶、小儿需氧瓶;法国生物梅里埃公司生产的api staph和ATB STAPH5试剂条,API 20C AUX酵母菌鉴定系统及ATB-Fungus药敏试验盒。结果医院总例次感染率为3.22%,其中以呼吸道最高,其次为泌尿、皮肤软组织;临床分离的致病菌为革兰氏阴性菌为主,占51.16%;真菌占35.65%;革兰氏阳性菌占13.19%。比较本院2000-2005年医院感染,条件致病菌构成比呈上升趋势。结论医院感染中条件致病菌有增高趋势,加强医院感染管理,积极治疗原发病,减少侵袭性操作,及时病原菌监测,合理使用抗菌药物是降低医院感染的有效措施。

Objective To analyse the clinical feature of nosocomial infections in general hospitals for the purpose of setting up efficient measures against it. Methods An analysis was made on the basis of the survey. The data came from 93680 hospitalized cases from 2000 to 2005. Bacterial identification was conducted with BarcT/Aiert 240 system, api staph and ATB STAPH5 reagent strip, API 20C AUX yeast fungus identifying system as well as ATB-fungus susceptibility test kit. Results The prevalence rate was 3. 22%, in which the main infection site was the upper respiratory tract, and followed by the lower respiratory tract and urinary tract. Among bacteria isolated from clinical cases, 51.16% were G-, 13.19% were G＋,and 35.65% were fungi. The proportion of conditional bacteria showed an increasing trend from 2000 to 2005. Conclusion The conditional bacteria show an increasing trend in the nosocomial infections . Strengthening the nosocomial infection management, treating underlying disease actively, minimizing invasive procedures, supervising towards pathogenic bacteria, and using antibacterial drugs rationally are effective strategies to reduce the rate of nosocomial infections.