信息化技术实时分析神经外科手术患者医院感染临床特点

Real-time analysis of characteristics of nosocomial infections in neurosurgery department patients by information technology

目的了解神经外科手术患者医院感染特点、病原菌分布及耐药性,为神经外科抗菌药物的合理使用及医院感染的控制提供科学依据。方法通过医院感染实时监控信息系统,监测及追踪2015年1月1日-2015年12月31日神经外科1877例手术患者,统计医院感染病例,并对医院感染特点进行分析。结果共追踪神经外科手术患者1 877例,其中发生医院感染113例,医院感染率为6.02%;医院感染部位以下呼吸道感染为主,占45.19%,其次为手术部位感染和尿管相关泌尿系感染,分别占17.78%和12.59%;113例感染患者中共分离出病原菌128株,以革兰阴性菌为主,占56.25%;肺炎克雷伯菌对美罗培南、亚胺培南耐药率为14.29%;大肠埃希菌对常用的青霉素类、头孢菌素类、喹诺酮类的耐药率多数≥60.00%,对美罗培南、亚胺培南的敏感率为100.00%;尚未发现耐万古霉素、利奈唑胺的金黄色葡萄球菌。结论神经外科作为医院感染的高发科室,连续、系统地监测其医院感染特点、病原菌分布及耐药性,对指导临床合理使用抗菌药物、有效控制医院感染具有重要意义。

OBJECTIVE To understand the characteristics of nosocomial infections in neurosurgery department patients undergoing surgeries and investigate the distribution and drug resistance of pathogens so as to provide scientific bases for reasonable use of antibiotics and control of the nosocomial infections.METHODS By means of the real-time monitoring information system for nosocomial infections,totally 1877 neurosurgery department patients who received surgeries from Jan 1,2015 to Dec 31,2015 were monitored and traced,the cases of nosocomial infections were taken for statistics,and the characteristics of the nosocomial infections were analyzed.RESULTS Of totally 1 877 neurosurgery department patients who were traced,113 had the nosocomial infections,with the incidence of nosocomial infections 6.02%.Among the patients with nosocomial infections,45.19% had lower respiratory tract infections,17.78% had surgical site infections,and 12.59% had catheter-related urinary tract infections.A total of 128 strains of pathogens were isolated from the 113 patients with infections,of which 56.25%were gram-negative bacteria.The drug resistance rates of the Klebsiella pneumoniae to meropenem and imipenem were 14.29%;the drug resistance rates of the Escherichia coli to penicillins,cephalosporins,and quinolones were no less than 60.00%,and the drug susceptibility rates to meropenem and imipenem were 100.00%;the Staphylococcus aureus strains that were resistant to vancomycin,linezolid have not found yet.CONCLUSION The neurosurgery department is a department at high risk of nosocomial infections.The continuous,systematic monitoring of the characteristics of the nosocomial infections,distribution,and drug resistance of the pathogens has great significance in guiding the reasonable clinical use of antibiotics and in effective control of the nosocomial infections.