产科医院感染临床特点与病原菌分析

Clinical characteristics of nosocomial infections and distribution of pathogens in obstetrics department

目的探讨产科医院感染临床特点及病原菌种类、分布及耐药性,为产科医院感染的预防治疗提供参考依据。方法回顾性分析2014年5月-2015年5月于医院产科分娩的1 850例产妇临床资料,记录医院感染率、感染部位、病原菌构成及其耐药性,数据采用SPSS 19.0软件进行统计分析。结果 1 850例产妇发生医院感染31例,感染率1.7%;医院感染部位主要为上呼吸道,11例占35.5%;共分离出47株病原菌,以革兰阴性菌为主,共21株占44.7%,其次革兰阳性菌18株占38.3%,真菌8株占17.0%;革兰阴性菌对亚胺培南、美罗培南、环丙沙星耐药率较低,均<25.0%;对其余抗菌药物均呈较高耐药率均>50.0%。结论革兰阴性菌是产科医院感染病原菌的优势菌,掌握产科医院感染特点及病原菌耐药特征,并制定相应的干预措施,对提高产妇和新生儿预后具有重要作用。

OBJECTIVE To explore the clinical characteristics of nosocomial infections and species,distribution,and drug resistance of pathogens in department of obstetrics so as to provide guidance for prevention and treatment of the nosocomial infections in the department of obstetrics.METHODS The clinical data of 1 850 puerpera who gave birth in the department of obstetrics from May 2014 to May 2015 were retrospectively analyzed,then the incidence of nosocomial infections,infection site,distribution and drug resistance of pathogens were recorded,and the statistical analysis of data was performed with the use of SPSS 19.0software.RESULTS The nosocomial infections occurred in 31 of 1 850 puerpera,with the infection rate 1.7%,and 11 patients had upper respiratory tract infections,accounting for 35.5%.A total of 47 strains of pathogens were isolated,of which 44.7%（21strains）were gram-negative bacteria,38.3%（18strains）were gram-positive bacteria,and 17.0%（8strains）were fungi.The drug resistance rates of the gram-negative bacteria to imipenem,meropenem,and ciprofloxacin were less than25.0%,while the drug resistance rates to the rest of antibiotics were more than 50.0%.CONCLUSION The gram-negative bacteria are dominant among the pathogens causing the nosocomial infections in the department of obstetrics.It is of great significance to understand the characteristics of nosocomial infections and drug resistance of pathogens and put forward targeted intervention measures so as to improve the prognosis of the puerpera and neonates.