老年死亡病例医院感染分析

Analysis of nosocomial infections in elder death cases

目的分析老年死亡病例医院感染分布特点、病原菌类型及其耐药特征。方法回顾性调查分析医院2009年1月-2012年4月237份老年死亡病历资料。结果 237例死亡患者中发生医院感染109例、113例次,医院感染率为46.0%、例次感染率为47.68%;恶性肿瘤和呼吸系统疾病患者医院感染率最高,分别为54.29%和50.00%;感染部位以呼吸道为主,占73.45%;病原菌以革兰阴性杆菌为主占69.14%,革兰阳性球菌占20.22%,真菌占10.64%;铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌对多数抗菌药物的耐药率>50.00%。结论老年死亡病例中医院感染率高,病原菌对常用抗菌药物的耐药率高、耐药谱广,高度重视感染患者的病原菌鉴定及药敏试验,定期监测细菌耐药性,为临床合理使用抗菌药物,控制医院感染具有重要意义。

OBJECTIVE To analyze the distribution and drug resistance characteristic of the pathogenic bacteria causing nosoeomial infections in elder death cases. METHODS The clinical data of eider inpatients who died in hospital from Jan. 2009 to Apr. 2012 were investigated and analyzed retrospectively. RESULTS Of the 237 elder death cases, nosocomial infections occurred in 109 cases with 113 case-times, with the infection rate of 46.0% and case-time infection rate of 47.68%. The malignant tumor and respiratory system diseases were with the highest infection rate （54. 29% and 50. 0%, respectively）. The respiratory tract was the main infected location, accounting for 73. 45%. Gram-negative bacilli were the predominant pathogens （69.14%）, followed by gram- positive cocci and fungi （20.22% and 10.64%, respectively）. The resistant rates of Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus to most antibiotics were higher than 50.0%. CONCLUSIONS The rate of nosocomial infection in eider death cases is high, and the pathogens possess broad antibiotic resistance spectrum and higher antibiotic resistance rate. Great emphasis on the identification and drug sensitive test of bacteria and regular surveillance for bacterial resistance have great significance in clinical reasonable use of antibiotics and the control of nosocomial infections.