抗菌药物预防应用在急性心肌梗死医院感染患者治疗中的效果分析

Efficacy analysis of antibiotics in the treatment of nosocomial infections in patients with acute myocardial infarction

目的探讨抗菌药物预防应用在急性心肌梗死医院感染患者中的效果,为合理使用抗菌药物提供临床依据。方法选取2011年3月-2014年5月收治的急性心肌梗死患者132例,将其随机分为对照组和观察组,每组各66例,对照组患者入院后按照急性心肌梗死的治疗方法处理,发生感染时使用抗菌药物治疗;观察组患者入院后按照急性心肌梗死治疗的同时,给予抗菌药物预防治疗,对比分析两组患者医院感染率、感染部位分布、患者的住院时间及病原菌种类,数据采用SPSS18.0软件进行处理。结果两组患者的医院感染率、感染部位及住院天数比较,差异无统计学意义;对照组患者检出病原菌34株,其中肠杆菌科细菌8株,3株为产ESBLs菌,检出率为37.50%,观察组患者检出病原菌33株,其中检出肠杆菌科细菌6株,5株为产ESBLs菌,检出率为83.33%,对照组ESBLs菌检出率显著低于观察组,差异有统计学意义(P<0.05)。结论应用抗菌药物预防急性心肌梗死患者的医院感染,不仅不能缩短急性心肌梗死患者的住院时间和降低感染率,反而导致真菌和耐药菌株的比例增加,增加了治疗心肌梗死的难度。

OBJECTIVE To investigate the efficacy of antimicrobial drugs in the prevention of nosocomial infection among acute myocardial infarction in patients with hospital infection,and to provide clinical basis for rational use of antimicrobial drugs.METHODS A total of 132 patients of acute myocardial infarction were selected in the study from Mar.2011 to May 2014.Patients were randomly assigned to control group（66cases）and observation group（66cases）.After admission,control group was given the treatment of acute myocardial infarction,and antibiotics were only used in the case of infection.Observation group was given treatment of acute myocardial infarction and antibiotics at the same time.Rate of nosocomial infections,distribution of infection sites,patient＇s hospital stay,and types of pathogens were compared.Data were analyzed with SPSS 18.0.RESULTS The difference of nosocomial infection rates,sites of infection and hospital stays between the two groups was not significant.Totally 34 pathogens were detected from control group,among them there were 8strains of Enterobacteriaceae,and three strains of ESBLs-producing bacteria,detection rate was 37.50%.There were 33 strains of pathogens in observation group,among them there were 6strains of Enterobacteriaceae,and five strains of ESBLs-producing bacteria,detection rate was 83.33%.The detection rate of ESBLs bacteria in control group was significantly lower than control group（P〈0.05）.CONCLUSION Using antibiotics to prevent nosocomial infections in patients with acute myocardial infarction can not shorten hospital stay in patients with acute myocardial infarction and reduce incidence of infections,instead it will lead to the increase of proportion of fungi and drug resistant pathogens,which will increase the difficulty in treatment of myocardial infarction.