神经外科择期手术患者医院感染的临床分析

Clinical analysis of nosocomial infections in neurosurgical patients undergoing selective operations

目的探讨神经外科择期手术患者医院感染的构成及其特征。方法对2007年1月-2009年12月37例神经外科择期手术患者医院感染病例临床资料进行回顾性研究和统计性分析。结果神经外科择期手术患者医院感染率为11.0%,脑积水分流术感染率为14.8%,居首位;前3位感染好发部位为肺部、颅内及切口,分别占40.5%、27.0%、21.1%,前3位病原菌分别为金黄色葡萄球菌、表皮葡萄球菌和鲍氏不动杆菌。结论神经外科择期手术患者医院感染以肺部、颅内及切口为最主要部位,感染菌株以革兰阴性杆菌为主,在革兰阳性球菌中以葡萄球菌属为主;抗菌药物的应用使得耐药菌株有日益增多趋势。

OBJECTIVE To explore the features and distribution of hospital acquired infections （HAIs） in neurosurgical patients who received selective operation. METHODS The clinical data on 37 neurosurgical patients with nosocomial infections undergoing selective operation between Jan 2007 and Dec 2009 were retrospectively surveyed and statistically analyzed. REsuLTs The infection rate of patients receiving selective operation was 11.0%, and the infection rate of the patients with hydrocephalus shunt was 14.8%, ranking the first plaee; the top 3 predisposing sites were the lung, intracranial brain, and the incision, accounting for 40.5%, 27.0%, and 21.1% ,respectively; the top 3 predominant pathogens were Staphylococcus aureus, S. epidermidis, and Acinetobacter baumanii. CONCLUSION The most common infection sites of neurosurgical patients undergoing selective operation are lung, intraealvarium, and incision~ the main pathogens causing infections are gram-negative bacteria, and the main species of gram-positive bacteria is Staphylococci spp ; the abuse of antibiotics has made the resistant strains an increasing trend.