患儿全身麻醉气管插管后呼吸道感染病原菌及危险因素分析

Distribution of pathogens causing respiratory tract infections in children undergoing endotracheal intubation under general anesthesia and risk factors

目的研究患儿全身麻醉气管插管后呼吸道感染病原菌分布特征及危险因素,为降低感染率提供参考依据。方法分析2014年11月-2015年11月于医院诊治962例全身麻醉气管插管患儿临床资料,调查呼吸道感染率,采用自拟问卷调查表对患儿基本情况进行调查,采用单因素和多因素logistic分析,采集患者痰液标本进行菌种鉴定和药敏试验。结果 962例患儿中40例发生呼吸道感染,感染率4.16%;分离出60株病原菌,其中37株革兰阴性菌占61.67%,18株革兰阳性菌占30.00%,5株真菌占8.33%。结论患儿全身麻醉气管插管后呼吸道感染病原菌分布相对较广,且危险因素较多,应根据危险因素和药敏试验合理选择抗菌药物进行干预、治疗。

OBJECTIVE To explore the distribution of pathogens causing respiratory tract infections in children undergoing endotracheal intubation under general anesthesia and analyze the risk factors so as to reduce the infection rate.METHODSThe clinical data of 962 children who underwent the endotracheal intubation under general anesthesia from Nov 2014 to Nov 2015 were observed,the incidence of respiratory tract infections was investigated,the basic information of the children was investigated by means of self-prepared questionnaires,the univariate analysis and multivariate logistic analysis were performed,the sputum specimens were collected and cultured so as to identify the pathogens,and the drug susceptibility testing was carried out.RESULTS Of the 962 children,40had respiratory tract infections,with the infection rate 4.16%.A total of 60 strains of pathogens were isolated,including 37（61.67%）strains of gram-negative bacteria,18（30.00%）strains of gram-positive bacteria,and 5（8.33%）strains of fungi.CONCLUSION The pathogens causing the respiratory tract infections in the children undergoing endotracheal intubation under general anesthesia are widely distributed,and there are a variety of risk factors.It is necessary to take interventions according to the risk factors and reasonably use antibiotics based on the result of the drug susceptibility testing.