心血管内科病房医院感染分析

Nosocomial Infections in a Cardiovascular Department

目的探讨心血管内科住院患者医院感染的特点、病原菌及药敏情况,为医院感染的预防与控制和治疗提供参考。方法对2007年1-12月心血管内科1343例住院患者在前瞻性监测的同时进行回顾性调查分析。结果发生医院感染例次60例,例次感染率为4.47%;医院感染发生的部位以下呼吸道居首位(56.67%);医院感染的病原菌主要为革兰阴性杆菌和真菌,各占37.78%;分离的革兰阳性球菌对替考拉宁、万古霉素高度敏感;革兰阴性杆菌对美罗培南、左氧氟沙星、替卡西林/克拉维酸最敏感;真菌对测试的抗真菌药物均敏感。结论心血管内科住院患者医院感染以呼吸道常见,病原菌以革兰阴性杆菌和真菌为主,药敏提示革兰阳性球菌耐药情况较严重,革兰阴性杆菌对多数药物敏感,真菌对所有测试的抗真菌药物均高度敏感。

OBJECTIVE To improve the prevention and treatment of nosocomial infection through investigating the characteristics, pathogenic microorganisms and their sensitivity to antibiotics of nosocomial infections in cardiovascular department. METHODS A prospective surveillance and retrospective analysis was made in 1343 patients hospitalized to the cardiovascular department during Jan 1st to Dec 31st in 2007. RESULTS Sixty cases of nosocomial infections were found, with case infection rate 4.47%. Lower respiratory tract （56.67%） was the most common site of infection. As to the pathogens of infection, Gram-negative bacilli and fungi were predominant （37. 78%）. Gram-positive cocci were hypersensitive to teicoplanin and vancomycin; most of Gram-negative bacilli were sensitive to meropenem, levoofloxacin and ticarcillin/clavulanic acid. Fungi were sensitive to all antimycotic drugs detected. CONCLUSIONS Respiratory tract is the most common site of nosocomial infection in cardiovascular department, Gram-negative bacilli and fungi are predominant paghogens. Drug resistance of Gram-positive cocci is serious, but Gram-negative bacilli are still sensitive to most antibiotics and fungi are sensitive to all antimycotic drugs detected.