1133例胸外科住院患者的医院感染调查分析

Hospital Infection among 1133 Thoraicic Surgery Patients

目的了解胸外科住院患者医院感染部位、病原学送检及抗菌药物耐药情况。方法对2008年1-12月入住胸外科的1133例患者临床资料进行调查统计、分析、评判。结果1133例胸外科住院患者,发生医院感染65例次,医院感染率5.74%,医院感染部位依次为呼吸道、胃肠道、泌尿道;院外和院内感染患者送检病原学标本340份,阳性标本数75份,阳性率为22.06%;痰液阳性标本59份,阳性率为38.31%;共分离出病原菌97株,检出前3位为白色假丝酵母菌、肺炎克雷伯菌、热带假丝酵母菌,分别占20.62%、18.56%、16.49%;白色假丝酵母菌和热带假丝酵母菌对氟康唑、伊曲康唑、5-氟胞嘧啶、两性霉素B均保持100.00%敏感,肺炎克雷伯菌对氨苄西林100.00%耐药,对头孢替坦、厄他培南、亚胺培南、左氧氟沙星、美罗培南、哌拉西林/他唑巴坦未发现耐药情况。结论胸外科医院感染以呼吸道感染为主,痰培养阳性率最高,检出病原菌以真菌和革兰阴性杆菌为主;采取以预防呼吸道感染为主的综合性防治措施,降低胸外科医院感染率。

OBJECTIVE To understand the pathogen distribution,constituent ratio and drug resistance of urinary system infection.METHODS The clinical data of 1133 thoraicic surgery（TS） patients from Jan 2008 to Dec 2008 were investigated,analyzed and evaluated.RESULTS From them 65 patients/times were with hospital infection,the rate was 5.74%.Hospital infection in respiratory tract was at first place,then were the gastrointestinal and urinary tracts.From 340 examined samples,75 were with positive results,the rate was 22.06%,the majority was from sputa with 38.31% of positive rate.From 97 isolates,the first 3 were Candida albicans（20.62%）,Klebsiella pneumoniae（18.56%） andC.tropicalis（16.49）.C.albicans and C.tropicalis were sensitive to fluconazole,itraconazole,5-flucytosine and amphotericin B.K.pneumoniae was resistant to ampicillin（100.00%）,but sensitive to cefotetan,Ertapenem,imipenem,levofloxacin,meropenem and piperacillin/tazobactam.CONCLUSIONS The main hospital infection is in respiratory tract.The positive rate of sputum culture is the highest,and the main bacteria are Gram-negative bacilli.Adopting comprehensive prevention and cure measures to obviate respiratory infection,the hospital infaction rate can be cut down.