乳腺外科患者术后医院感染病原学和高危因素分析

Analysis of etiology and high risk factors of nosocomial infection in breast surgery patients

目的观察乳腺外科患者术后医院感染病原学特征,对感染的高危因素进行分析,为判定感染的预防措施提供参考。方法收集2015年1月至2016年9月本院乳腺外科行乳腺肿物手术患者436例资料,根据是否发生医院感染分组,感染组37例,统计感染部位、病原菌种类;未感染组399例,比较两组基本情况,治疗相关指标,以感染为自变量,手术持续时间、营养状况、抗生素使用等为因变量,采用多因素Logistic回归分析。结果感染组37例患者共培养出病原菌46株,包括G-球菌33株,占71.74%,G+球菌11株,占23.91%,真菌2株,占4.35%。合并糖尿病、手术时间持续≥60 min、营养状况差是乳腺手术后医院感染的高危因素,预防性使用抗生素是保护因素。结论乳腺外科患者医院感染病原菌以G-球菌为主,手术时间长、营养不良、合并糖尿病是医院感染的高危因素,应采取措施加以预防。

Objective To observe the breast surgery patients postoperative nosocomial infection etiology characteristics,analyze the risk factors of infection,to provide reference for the establishment of preventive measures of infection. Methods Collected from January 2015 to September 2016 breast surgery,436 cases of patients with breast neoplasm surgery,according to the group of nosocomial infection,37 cases of infection group,the location of infection and the type of pathogenic bacteria were counted,and 399 cases were not infected,the basic situation of the two groups,treatment related indicators,infection as independent variable,duration of operation,nutritional status,antibiotic use as dependent variables,multivariate Logistic regression analysis was used.Results In the infection group,46 strains of pathogenic bacteria were cultured,including 33 strains of Gcoccus,71.74%,G＋cocci 11,23. 91%,fungi 2,accounting for 4. 35%,37. The operation time of diabetes,aged 60 min, persistent poor nutritional status were risk factors for hospital infection after breast surgery,prophylactic use of antibiotics was a protective factor. Conclusions The main pathogens of nosocomial infection in breast surgery patients are G-cocci. The operation time is long,malnutrition and diabetes mellitus are high risk factors of nosocomial infection,and measures should be taken to prevent them.