手术患者医院感染的病原菌分布与控制

Distribution of pathogens causing nosocomial infections in surgery patients and control measures

目的观察分析手术患者感染的病原菌分布及其耐药性,探讨临床预防对策。方法选取2012年1月1日-2014年1月1日的567例常规外科手术患者,对手术感染患者进行病原菌培养及药敏试验,并对感染相关因素进行logistic回归分析,探讨预防措施。结果 567例手术患者中发生感染69例,感染率为12.17%;共分离病原菌54株,其中革兰阳性菌48株占88.88%,革兰阴性菌3株占5.56%,真菌3株占5.56%;革兰阴性菌对庆大霉素、头孢哌酮的耐药率较高,革兰阳性菌对头孢唑林、克林霉素、红霉素、环丙沙星的耐药率较高;单因素分析显示,年龄、手术室级别、参观人数与手术感染的发生具有相关性(P<0.05);多因素logistic回归分析显示,年龄、手术室级别、参观人数是手术感染的独立危险因素。结论手术感染严重威胁着患者的生命健康,临床应对手术室级别和参观人员数量等因素进行干预控制,避免手术感染的发生。

OBJECTIVE To observe the distribution and drug resistance of the pathogens causing infections in the surgery patients and put forward the clinical prevention countermeasures.METHODS A total of 567 patients who underwent the conventional surgery from Jan 1,2012 to Jan 1,2014 were enrolled in the study,then the pathogens were cultured for the surgery patients with infections,the drug susceptibility testing was conducted,the logistic regression analysis was performed for the related factors for the infections,and the prevention measures were formulated.RESULTS The infections occurred in 69 of 567surgery patients,with the infection rate of12.17%.Totally 54 strains of pathogens were isolated,including 48（88.88%）strains of gram-positive bacteria,3（5.56%）strains of gram-negative bacteria,and 3（5.56%）strains of fungi.The gram-negative bacteria were highly resistant to gentamicin and cefoperazone;the gram-positive bacteria were highly resistant to cefazolin,clindamycin,erythromycin,and ciprofloxacin.The univariate analysis indicated that the incidence of the infections in the surgery patients was associated with the age,grade of operating room,and number of visiting people（P〈0.05）.The multivariate logistic regression analysis showed that the age,grade of operating room,and number of visiting people were the independent risk factors for the infections in the surgery patients.CONCLUSIONThe surgical infections threaten the health of the patients.It is necessary for the hospital to take interventions to the grade of operating room and the number of visiting people so as to prevent the surgical infections.