SICU病人院内感染的临床与病原分析

自1994年12月至1996年4月连续收集术后转入SICU监护10 d以上,有明确院内感染证据的危重病人共14例,结果提示SICU病人院内感染的特点之一是多部位感染,具体感染部位数与手术方式及采用侵入性诊疗操作密切相关;细菌学研究发现当今主要感染致病菌G^+球菌已上升至35.7％,多重耐药菌株的出现和二重感染的并发预示合理而有效联合应用抗生素的重要性。

To evaluate the epidemiology of nosocomial infection in surgical intensive care unit(SICU) and its drug sensitivity of pathogenesic bacteria. A retrospective study was carried out. In this study 14 successive patients in SICU of Zhongshan hospital (admission days≥10) between December 1994 to April 1996 were included. The characteristics of these patients were as follows: 85.8 % of these multiple-site infections. The commoninfectionsite were lungs, abdominal incision, blood, digestive and urinary system in order. Among the pathogenesic organisms, Gram - positive cocci, Gram - negative bacilli, fungi accounted for 35.7 % , 58. 3 % , 6 % respectively. Gram- positive cocci were sensitive to vancomycin and rifampicin with a sensitivity rati of 84. 5 % and 69 % , whereas the Gram - negative bacilli were sensitive to amikacin and tobramycin (sensitivity rate 44. 8 % , 43.1 %). The reasons of nosocomaial infections in SICU were; malnutrition, immune - depression caused by operation, frequent use of invasive diagnosis and treatment procedures, abuse of broad - spectrum antibiotics. The management of these patients include: intensive nutritional and supportive treatment, correct use of antibiotics.