肿瘤专科医院患者手术部位感染的调查与分析

Investigation and analysis of surgical site infections in cancer hospital

目的分析中山大学附属肿瘤防治中心住院患者手术部位感染(SSI)状况,为医院感染预防控制提供依据。方法对2007年1月-2011年12月肿瘤中心发生的SSI采用现况调查方法进行监控,及时填写统一制定的医院感染监测登记表,并予上报,并对198例发生SSI住院患者的临床资料进行调查分析,采用SPSS16.0软件进行统计分析,计数比较采用χ2检验。结果 2007-2011年住院患者SSI发生率分别为0.44%、0.33%、0.41%、0.30%和0.43%;198例发生SSI的住院患者主要来自胸科、结直肠科、胃胰科和肝胆科,分别占28.28%、17.17%、12.12%和11.62%;术后对所有患者预防性应用抗菌药物,其中167例应用广谱抗菌药物;153例SSI患者中检出病原菌143株,以革兰阴性杆菌为主,占69.93%,真菌感染占24.84%。结论肿瘤中心SSI发生率相对较低且波动不大,主要以革兰阴性杆菌为主的器官或组织腔隙感染,术后预防性应用抗菌药物未能避免术后感染的发生。

OBJECTIVE To investigate the incidence of surgical site infections （SSI） in the hospitalized patients of Sun Yat- sen University Cancer Center so as to provide basis for the prevention of nosocomial infections. METHODS The current status survey was conducted to monitor the SSI that occurred in the cancer center from Jan 2007 to Dec 2011, then the unified monitoring registration tables of nosocomial infections were filled out in a timely manner and were reported~ and the clinical data of 198 cases of hospitalized patients were investigated and analyzed, the statistical analysis was performed with the use of SPSS16. 0 softwane, and chi-square test was performed for the count data. RESULTS The incidence rate of SSI was 0.44% in 2007, 0.33% in 2008, 0.41% in 2009,0.3% in 2010, and 0.43% in 2011. Of 198 cases of hospitalized patients with SSI , 28.28% of the patients were from thoracic surgery department, 17. 17% from colorectal surgery department, 12. 12% from pancreatic surgery department, and 11.62 % from hepatobiliary surgery department. Of all patients who used antibiotics for prophylaxis, 167 cases used broad spectrum antibiotics. Of the 153 cases of patients with SSI, totally 143 strains of pathogens were isolated , among which the gram-negative bacilli accounted for 69. 93%, the fungi 24.84%. CONCLUSION The incidence rate of SSI is relatively low and with low fluctuation in the tumor center, the gram- negative bacilli are the predominant pathogens causing organ or tissue cavity infections; the postoperative antibiotics prophylaxis is failed to prevent the infections.