重型肝炎继发医院感染的临床分析

Fulminant Hepatitis Secondary Clinical Analysis of Nosocomial Infection

目的探究与分析重型肝炎继发医院感染的情况。方法整群选取该院自2012年11月—2014年11月间收治的重型肝炎患者162例,对这些患者有无继发感染、感染部位等进行分析对比。结果在选取的162例重型肝炎患者中,继发医院感染者共57例,占35.2%,未继发医院感染者105例,占64.8%。在继发感染者中,腹腔感染最突出,有28例,占17.3%。其他感染依次为胆道感染14例,占8.6%,呼吸道感染9例,占5.6%,血液感染4例,占2.5%,其他感染3例,占1.9%。其中,1例患者合并2种感染。对病原菌进行检测,结果显示:共检出病原菌36株,各类病原菌中,革兰阴性菌居多,共19株,占52.3%,革兰阳性菌共11株,占30.6%,真菌共6株,占16.7%。各种病原菌中,大肠杆菌数量最多,共9株,占25.0%,其他数量较多的病原菌依次为肺炎克雷伯菌7株,占19.4%;金黄色葡萄球菌5株,占13.9%;白色念珠菌4株,占11.1%;溶血性链球菌3株,占8.3%。结论重型肝炎易于继发医院感染,感染的病原菌种类较多,且引起的病情较重,预后较差,有必要较早采取防治措。

Objective To probe into and analysis of secondary hospital infection of severe hepatitis. Methods To choose self court-yard from November 2012 to November 2012 were 162 cases of patients with severe hepatitis, with or without secondary infection, infection in patients with these parts and other analysis comparison. Results 162 cases of fulminant hepatitis in selected patients, secondary hospital infection, a total of 57 cases （35.2%）, secondary hospital infection in 105 cases, accounting for 64.8%. In the secondary infection, abdominal cavity infection, the most prominent have 28 cases, accounting for 17.3%. Other 14 cases of infec-tion of biliary tract infection （8.6%）, respiratory infection, 9 cases （5.6%）, blood stream infection, 4 cases （2.5%）, other 3 cases of infection, accounting for 1.9%. Among them, 1 case of patients with combined two kinds of infection. To test the pathogen, the re-sults showed：a total of 36 strains pathogenic bacteria detection of various kinds of pathogens, the majority of gram-negative bacte-ria, a total of 19 strains （52.3%）, gram positive bacteria, a total of 11 strains, accounting for 30.6%, fungi, a total of 6 strains, ac-counting for 16.7%. The most number of various kinds of pathogenic bacteria, escherichia coli, a total of 9 strains, accounting for 25.0%, other large number of pathogenic bacteria of pneumonia klebsiella bacteria strains, accounting for 19.4%; Staphylococcus aureus, 5 strains （13.9%）, Candida albicans 4 strains （11.1%）, Hemolytic streptococcus 3 strains, accounting for 8.3%. Conclusion Easy to fulminant hepatitis secondary hospital infection, the infection of pathogenic bacteria species, and cause of disease, poor prognosis, it is necessary to take early prevention and control measures.