某院神经外科医院感染病原菌特征及危险因素分析

Pathogenic bacteria characteristics and risk factors of nosocomial infection of patients in Neurology & Neurosurgery in a hospital

目的分析武警后勤学院附属医院神经外科医院感染的病原菌特征与感染危险因素,探讨医院感染的防治措施。方法采用回顾性分析法对2012年至2014年本院神经外科医院感染的病原菌特征以及危险因素等临床资料进行分析。结果共分离出450株病原菌,以革兰阴性菌为主,占90.89%(409/450),革兰阳性菌占7.11%(32/450),真菌占2.00%(9/450),其中,分布最广的4种病原菌为肺炎克雷伯菌(30.00%,1 35/450)、铜绿假单胞菌(27.11%,122/450)、鲍曼不动杆菌(14.22%,64/450)和大肠埃希菌(9.11%,41/450)。革兰阴性菌对头孢曲松、复方磺胺甲噁唑、氨曲南等普遍耐药。基础疾病、侵入性治疗、广谱抗菌药物长期使用、机械通气和白蛋白低等可能是医院感染者预后的危险因素。结论本院神经外科多重耐药革兰阴性菌呈流行趋势,基础疾病、侵入性治疗、广谱抗菌药物长期使用、机械通气和白蛋白低与医院感染者预后密切相关。

Objective To analyze the pathogenic bacteria characteristics and risk tactors for nosocomial infection of patients in Neurology ＆ Neurosurgery in Hospital of the Chinese People＇s Armed Police Force, and to investigate the prevention and cure measures for nosocomial infection. Methods The clinical data of pathogenic bacteria characteristics and the risk factors of iatrogenic infection of neurosurgery inpatients in our hospital from 2012 to 2014 were reviewed, retrospectively. Results Among the 450 strains of pathogens isolated, Gram-negative bacteria were predominant pathogens, accounting for 90.89% （409/450）, Gram-positive cocci accounted for 7.11% （32/450）, and fungi accounted for 2.00% （9/450）, the 4 species of pathogens most widely distributed were Klebsiella pneumonia （30.00%, 135/450）, P. aeruginosa （27.11%, 122/450）, Acinetobacter baumannii （14.22%, 64/450） and E. coli （9.11%, 41/450）. Gram-positive cocci was resistant to ceftriaxone, compound sulfamethoxazole, aztreonam, etc. Underlying diseases, invasive treatments, long-term and broad-spectrum antibiotic therapy, mechanical ventilation, low albumin maybe the risk factors of the prognosis of patients with nosocomial infection. Conclusions Multi-drug resistant Gram-negative bacteria showed a trend of fashion in neurosurgery of our hospital. Underlying diseases, invasive treatments, long-term and broad-spectrum antibiotic therapy, mechanical ventilation and low albumin were closely related with the prognosis of patients with nosocomial infection.