脑瘫康复病区院内感染分析

Hospital Onset of Infection Analysis of Cerebral Palsy Rehabilitation Ward

目的探讨脑瘫康复病区院内感染的特点,为临床合理用药提供依据。方法收集2008年住院治疗且明确为院内感染的157例脑瘫患儿的临床资料、病原体检查结果及药敏试验结果进行分析。结果院内感染率为15.87%(157/989);157例院内感染脑瘫患儿中呼吸道感染占93.63%(147/157),其中细菌感染占71.43%(105/147),支原体感染占5.44%(8/147)。消化道感染占6.37%(10/157),其中轮状病毒感染占90%(9/10);共分离出革兰氏阴性杆菌57例,占54.28%,按构成比依次为肺炎克雷伯氏菌、鲍氏不动杆菌、大肠埃希菌、铜绿假单胞菌;革兰氏阳性球菌(金黄色葡萄球菌)7例,占6.66%,革兰氏阴性球菌(卡他布兰汉菌)41例,占39.05%。药敏试验显示:复方新诺明对球菌的耐药率达100%;苯唑西林、万古霉素、亚胺培南对金黄色葡萄球菌敏感率为100%,头孢噻吩、阿莫西林-克拉维酸、头孢呋辛对卡他布兰汉菌及金黄色葡萄球菌的的敏感率达100%;阿莫西林-克拉维酸、哌拉西林对革兰氏阴性杆菌的敏感率达70%以上。氨苄西林对革兰氏阴性杆菌的耐药率达60%;头孢他定对铜绿假单胞菌的敏感率为100%。结论脑瘫康复病房院内感染的发生率远高于普通儿科病房,且以呼吸道感染占绝大多数,病原体以革兰氏阴性杆菌占优势,卡他布兰汉菌为脑瘫康复病房院内感染最常见的病原体。

Objective To investigate the characteristic of HOI of cerebral palsy rehabilitation ward and provide evidence for rational admin istration. Methods Files of clinical data, infectors and susceptibility tests of 157 HOI children with cerebral who were admitted to hospital were analyzed. Results The HOI rate was 15.87%.The constituent ratio of respiratory infection was 93.63% and the alimentary infection was 6.37%. A mong the cases of respiratory infection, the constituent ratio of bacterial infection was 71.43 and the mycoplasma infection was 5.44%. 57 Gram-Negative bacillus were separated. According to the constituent ratio, the sequence fi＇om high to low was K. Peumoniae, A.baumannii, Es cherichia coli, Pseudomonas aeruginosa. 7 Gram-Positive coccus and 41 Gram-negative coccus were separated. The susceptibility test displayed that the drug fast rate of SMZ-TMP for coccus was 100% and ampicillin for Gram-Negative bacillus was above 60%. The sensitive rate of oxacillin,vancomycin, imipenem for Staphylococcus aureus were 100% and cafalotin,amoxicillin-clavulanic acid, cefuroxime for Staphylocoeeus aureus and B.catarrhalis were 100%. The sensitive rate of amoxicillin-clavulanic acid and piperacillin forGram-Negativebacillus were above 70%. The sensitive rate of ceftazidime for Pseudomonas aeruginosa was 100%. Conclusion The HOI rate of cerebral palsy rehabilitation ward is higher than that of common pediatrics ward. Respiratory infection predominate in the infections and B.catarrhalis is the main infector.