268株革兰阴性杆菌引起的医院感染临床分析

Nosocomial Infection Caused by 268 G^- Pathogen Strains:A Clinical Analysis

目的了解医院内革兰阴性杆菌感染的临床特点,探讨有效的管理措施。方法对医院2007年1月~2008年12月革兰阴性杆菌引起的医院感染病例进行调查分析。结果268株革兰阴性杆菌引起的医院感染病例中,大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌分别占38.81%、25.00%和12.69%;感染部位中呼吸道和泌尿道分别占51.49%及26.87%;患者感染前使用三代头孢菌素占73.51%、接受过气管插管、使用过呼吸机的患者占24.25%、入住ICU占20.52%、住院时间>30 d占47.01%。结论医院革兰阴性杆菌感染主要与感染前使用三代头孢菌素、气管插管、使用过呼吸机、入住ICU、长期住院等因素密切相关,医院革兰阴性杆菌的预防与控制是医院感染管理的重点。

OBJECTIVE To study the Gram-negative（G-） pathogen infection situation in a general hospital and to seek the controlling and management measures. METHODS An investigation of 268 cases of nosocomial infection caused by G^- pathogens was carried out from Jan 2007 to Dec 2008 in this hospital. RESULTS The clinical G^- pathogen isolates were mainly Escherichia coli （38.81%）, Klebsiella pneumoniae （25.00 %）and Enterobacter cloacae（12.69%）. Respiratory tract （51.49%） and urinary tract（26.87%） were the most frequent infection sites. The major correlated factors of G^- pathogen infection were use of the third generation of cephalosporins （73.51%） ,tracheal intubation and breathing machine used（24.25%）, admission to ICU （20.52%）and long term hospitalization（47.01%）. CONCLUSIONS The predisposing factors are previous use of the third generation of cephalosporins,tracheal intubation and breathing machine used, admission to ICU and long term hospitalization. To prevent and control G pathogen infection is the key point of nosocomial management.