冠状动脉旁路移植术医院感染病原菌分析

Pathogenic bacteria causing nosocomial infections in 9375 patients after coronary artery bypass grafting

目的总结北京市冠状动脉旁路移植术(CABG)术后感染情况,分析CABG医院感染的危险因素及控制环节,更好地控制感染,降低病死率。方法北京市医院感染管理质量控制和改进中心组织本市多中心进行CABG目标性监测。结果调查2008-2010年3年CABG手术9375例,检出病原菌249株,检出率为2.66%,其中鲍氏不动杆菌、铜绿假单胞菌、白色假丝酵母菌、表皮葡萄球菌、肺炎克雷伯菌位居前5位,分别占27.31%、12.45%、9.64%、8.43%、8.43%。结论对CABG术后感染,应根据实际情况和参考统计信息,采取针对措施,加强医院感染危险因素的预防控制,合理应用抗菌药物,控制医院感染,保障患者手术安全。

OBJECTIVE To investigate the incidence of infections in Beijing after the coronary artery bypass grafting（CABG）and analyze the risk factors of nosocomial infections after CABG and the control links so as to control the infections and reduce the mortality.METHODS The targeted monitoring of CABG was performed in Beijing Hospital Infection Control Quality Management and Control Center.RESULTS Of totally 9375 CABG cases investigated in 2008-2010,there were 249strains o f pathogens isolated with the detection rate of 2.66%,among which the Acinetobater baumannii,Pseudomonas aeruginosa,Candida albicans,Staphylococcus epidermidis,and Klebsiella pneumoniae ranked the top five species,accounting for 27.31%,12.45%,9.64%,8.43%,and 8.43%,respectively.CONCLUSION For the CABG patients after infections,it is necessary to take targeted measures,strengthen the prevention of risk factors of nosocomial infections,and reasonably use antibiotics so as to control the nosocomial infections and ensure the safety of operation.