某医院心脏外科手术患者医院感染病原菌及耐药性研究

Study on pathogenic characteristics and drug resistance of hospital acquired infection in patients of department of cardiac surgery

目的了解心脏外科手术患者医院感染病原菌特点及耐药性,为临床合理使用抗菌药物提供依据。方法通过回顾性调查方法,对某医院986例心脏外科手术患者医院感染状况和感染病原菌特点及其耐药性进行调查与评价。结果该医院986例心脏外科手术患者中,共查出医院感染患者64例、76例次,感染发生率为6.49%、感染例次率为7.71%。共分离出病原菌98株,其中革兰阴性杆菌、革兰阳性球菌和真菌构成比依次为70.4%、19.4%和10.2%;排名前三位的病原菌为铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯菌。居前3位的病原菌均对庆大霉素和头孢类耐药率较高,仅对碳青霉烯类抗菌药物比较敏感。结论心脏外科手术患者医院感染病原菌以革兰阴性杆菌为主,对临床常用抗菌药物普遍耐药,应加强药敏试验,严格管理抗菌药物的应用。

Objective To study the pathogenic characteristics and the drug resistance of hospital acquired infection in patients of department of cardiac surgery,so as to provide the guidance of rational use of antibiotics. Methods Retrospective survey was used to investigate and analysis the hospital infection status and the pathogenic characteristics of 986 patients hospitalized in the department of cardiac surgery. Results A total of 986 patients were investigated,among them 64 patients and 76 cases had hospital infection,infection rate and case infection rate were 6. 49% and 7. 71%. 98 strains of pathogenic bacteria were isolated,of which 70. 4% were Gram-negative bacilli,19. 4% were Gram-positive cocci and10. 2% were fungus. The top three pathogens were Pseudomonas aeruginosa,Acinetobacter baumannii and Pneumonia klebsiella bacteria,which showed a higher resistance rate to gentamicin and cephalosporins and lower resistance rate to penicillium carbon alkene antimicrobial agents. Conclusion Gram negative bacilli is the main hospital infection pathogens of patients hospitalized in the department of cardiac surgery,which showed a high resistance to most of clinical used antimicrobial agents. It is necessary to strengthen the test of drug sensitive and management of application of antimicrobial agents.