148例行超声介入治疗的医院感染者危险因素及防控措施

Risk factors, prevention and control measures of 148 cases with nosocomial infections by ultrasound interventional treatment

目的探讨超声介入治疗过程中存在的医院感染危险因素,为预防和控制感染提供临床依据,以降低医院感染的发生。方法选取2012年8月至2014年12月入本院行超声介入治疗的148例患者纳入本研究。病原菌的培养和分离采用BACTEC 9000系统,药敏试验采用K-B琼脂法进行,药敏结果判定依据CLSI 2005年标准;数据分析处理采用SPSS 17.0软件。结果本院超声介入治疗患者医院感染率为11.63%;患者发生医院感染危险因素有年龄、侵入性治疗、住院时间、应用抗菌药物以及合并其他疾病等。148例患者中发生医院感染者29例,共分离病原菌31株,其中革兰阴性菌17株(占54.84%),革兰阳性菌14株(占45.16%);革兰阳性菌对乙酰唑胺和替考拉宁较敏感,革兰阴性菌对美罗培南和亚胺培南较敏感。结论了解发生医院感染的危险因素对控制超声介入治疗感染的发生具有一定指导意义;当发生医院感染时,应根据药敏试验结果选用相对敏感的抗菌药物进行治疗。

Objective To investigate the risk factors of nosocomial infection during the ultrasound interventional treatment, and to provide a clinical basis for the prevention and control of infection, in order to reduce the incidence of nosocomial infection. Methods Total of 148 patients with ultrasound interventional treatment in our hospital were selected from August 2012 to December 2014. The culture and separation of pathogenic bacteria were carried out by BACTEC 9000 System, and the drug susceptibility test was carried out by K-B AGAR method, and the results of the drug sensitization were determined according to the CLSI 2005 standard. Data analysis was analyzed by SPSS 17.0. Results The nosocomial infection rate was 11.63% among the patients treated by ultrasonic interventional therapy. The age, invasive treatment, hospitalization time and application of antibiotics were all risk factors of nosocomial infection. There were 29 cases with nosocomial infection among the 148 patients, and 31 strains of pathogenic bacteria were detected. There were 17 strains （54.84%） of Gram negative bacteria and 14 strains （45.16%） of Gram positive bacteria. Gram positive bacteria were sensitive to teicoplanin and acetazolamide, while the Gram negative bacteria were sensitive to meropenem and imipenem. Conclusions Understanding the risk factors of hospital-acquired infection had some guiding significance for controlling the infection of ultrasonic intervention. When nosocomial infection occurs, it should be treated with relatively sensitive antimicrobial agents based on the experimental results of the drug.