麻醉患者医院感染临床特征分析

Clinical characteristics of nosocomial infections in anesthesia patients

目的探讨麻醉患者医院感染的临床特征,为临床医院感染的防治提供指导。方法回顾性分析2012年1月-2014年12月689例行麻醉手术治疗患者的临床资料,统计医院感染率、感染部位分布、病原菌种类及感染相关因素;采用SPSS 12.0软件对数据进行统计分析。结果 689例患者发生医院感染42例,医院感染率6.10%;医院感染部位以呼吸道和手术部位感染为主,分别占69.05%和19.05%;42例感染患者中共分离出42株病原菌,其中革兰阴性菌27株占64.29%,革兰阳性菌12株占28.57%,真菌3株占7.14%;排名前3位的病原菌依次为铜绿假单胞菌、金黄色葡萄球菌和肺炎克雷伯菌,分别占38.10%、21.43%和14.29%;相关因素分析显示,年龄、麻醉方式、麻醉时间、是否使用呼吸机和预防使用抗菌药物与医院感染的发生具有相关性(P<0.05)。结论呼吸道和手术部位是麻醉患者医院感染的主要部位,感染病原菌以革兰阴性菌为主,且医院感染与多种因素有关。

OBJECTIVE To explore the clinical characteristics of nosocomial infections in anesthesia patients so as to provide guidance for clinical prevention and treatment of the nosocomial infections.METHODS The clinical data of689 patients who underwent anesthesia surgeries from Jan 2012 to Dec 2014 were retrospectively analyzed,then the incidence of nosocomial infections,infection sites,species of pathogens,and related factors for the infections were taken for statistics,and the statistical analysis of data was performed with the use of SPSS 12.0software.RESULTS The nosocomial infections occurred in 42 of 689patients,with the infection rate 6.10%;of the patients with nosocomial infections,69.05% had respiratory tract infections,and 19.05% had surgical site infections.Totally 42 strains of pathogens were isolated from the 42 patients with infections,including 27（64.29%）strains of gram-negative bacteria,12（28.57%）strains of gram-positive bacteria,and 3（7.14%）strains of fungi;the Pseudomonas aeruginosa,Staphylococcus aureus,and Klebsiella pneumoniae ranked the top three species of pathogens,accounting for 38.10%,21.43%,and 14.29%,respectively.The analysis of the related factors showed that the incidence of the nosocomial infections was associated with the age,mode of anesthesia,time of anesthesia,use of ventilator,and prophylactic use of antibiotics（P〈0.05）.CONCLUSIONThe respiratory tract and surgical site are the major infection sites,the gram-negative bacteria are dominant among the pathogens causing the infections,and the incidence of the nosocomial infections is related to multiple factors.