妇产科患者医院感染病原菌的耐药性及其预后分析

Analysis of drug resistance and prognosis of nosocomial pathogens in obstetrics and gynecology patients

目的通过对妇产科患者医院感染病原菌耐药性及预后分析,为合理用药及控制医院感染提供依据。方法分析3 618例妇产科患者资料。结果 3 618例妇产科患者发生医院感染301例,感染率为8. 3%;分离病原菌386株,常见病原菌主要是革兰阴性杆菌238株(61. 7%),以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯杆菌、鲍氏不动杆菌为主,其次是革兰阳性球菌100株(25. 9%),以金黄色葡萄球菌、肠球菌属、表皮葡萄球菌为主,真菌48株(12. 4%),以白色假丝酵母菌为主;常见病原菌耐药性较高。结论妇产科患者常见病原菌耐药性较高,应依据药敏试验结果合理用药;预后诊治措施是强化护理,从防治泌尿道感染、基础疾病、呼吸道感染、缩减住院时间、加强术后护理、执行规章制度与宣教、密切观察病情、防控耐药菌传播等进行诊治。

Objective To provide scientific basis for the rational drug use and controlling hospital infection by the analysis of drug resistance and prognosis of nosocomial pathogens in obstetrics and gynecology patients. Methods The data of 3 618 patients were analyzed. Results A total of 301 cases suffered hospital infection in the 3 618 cases,and the infection rate was8. 3%. 386 strains of pathogenic bacteria were isolated,and the common pathogens were mainly 238 Gram-negative bacillus（61. 7%）（mainly Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,Acinetobacter baumannii）,followed by100 Gram-positive cocci（25. 9%）（mainly Staphylococcus aureus,Enterococcus,Staphylococcus epidermidis）,and 48 Fungus（12. 4%）（mainly Candida albicans）. The common pathogens had high resistance. Conclusion Due to the high drug resistance of common pathogens in obstetrics and gynecology patients,rational drug use should be based on drug sensitive test results. The factors affecting the prognosis are to strengthen clinical care,prevent and improve prognosis by control urinary tract infections,basic diseases,respiratory infections,reduce hospitalization time,strengthen postoperative care,enforce the rules and regulations,and carry out propaganda and education,closely observe the progress of the disease,and prevent the spread of drug-resistant bacteria.