微生物学检验在医院感染检测中的应用价值

Application value of microbiology test in nosocomial infection detection

目的研究外科手术后微生物学检验在医院感染检测中的应用价值。方法选取我院外科手术后发生感染的82例患者为研究对象,将患者按照随机数字表法分为观察组与对照组,各41例。两组患者均给予早期经验性抗菌药物治疗,观察组患者给予微生物学检验,分析病原菌种类及其对抗菌药物的耐药性,待细菌培养鉴定结果报告后,再选择对病原菌敏感性高的药物进行治疗,比较两组患者的感染清除率。结果观察组41例患者中共分离出49株病原菌,革兰阳性菌36株,占73.47%;革兰阴性菌10株,占20.41%;真菌3株,占6.12%。革兰阳性菌所占比例显著高于革兰阴性菌和真菌(P<0.01)。左氧氟沙星、青霉素、红霉素耐药性均较高,而万古霉素最低。观察组患者的感染清除率为92.68%(38/41),明显高于对照组患者的65.85%(27/41)(χ~2=8.979,P=0.003)。结论外科手术患者术后医院感染主要为革兰阳性菌感染,通过药敏试验,选择耐药性低的万古霉素进行治疗,可有效提高感染清除率,可为医院感染的诊治及预防提供指导。

Objective To study the application value of postoperative microbiological examination in the detection of nosocomial infection. Methods A total of 82 patients with infection after surgery in our hospital were selected as the study subjects, and were divided into observation group and control group according to the random method, with 35 cases in each group. The two groups were given early empiric antibiotic therapy, then patients in the observation group were given microbiological examination to analyze the pathogen species, choose drugs with high susceptibility for treatment after the bacterial culture identification results, the infection clearance rate were compared in the two groups. Results A total of 49 pathogens were isolated from 41 patients in the observation group, with 36 strains of Gram-positive bacteria, accounting for73.47%; with 10 cases of Gram-negative bacteria, accounting for 20.41%; with 3 strains of fungi, accounting for 6.12%;The proportion of Gram-positive bacteria was significantly higher than that of Gram-negative bacteria and fungi（P〈0.01）.Levofloxacin, penicillin, erythromycin had higher drug resistance, and vancomycin was the lowest. The infection clearance rate in the observation group was 92.68%（38/41）, which was higher than 65.85%（27/41） of the control group（ χ^2=8.979,P =0.003）. Conclusion The mainly postoperative nosocomial infection of surgical patients is Gram-positive bacteria infection, select the low resistance of vancomycin for treatment through drug sensitivity test, provide guidance for the diagnosis and treatment of nosocomial infection.