神经内科ICU患者细菌感染及耐药牲的危险因素分析

Analysis of risk factors of bacterial infection and drug resistance in patients with ICU neurology

目的 探讨神经内科ICU住院患者预防发生细菌感染措施及耐药性的危险因素,对患者所处病房进行微生物检测分析。方法 选取襄城县人民医院神经内科ICU病房进行治疗的2481例重症患者进行临床监测观察。本次研究采用病理学及微生物学对以感染患者及患者病房(空气、床单用品)、进行监测分析。结果 2481例患者中感染110例(4.43%),多重感染42例(38.18%);检测出总呼吸道感染患者以下呼吸道感染占比76.92%;感染患者病原菌主要以肺炎克雷伯菌、铜绿假单胞菌,两种病菌总占比为44.08%;病房发现空气与床单用品存在的病菌有葡萄球菌3例,病房及床单用品存在藤黄微球菌1例,同时还检测出鲍氏不动杆菌以及大肠埃希菌等。结论 ICU病房内出现致病菌,会导致患者在服药及治疗过程中出现抗药性,主要造成病菌的原因是空气、床单用品中存在的微生物,多重感染患者与空气、床单用品所检测出来的微生物分布具有相同特性,造成患者细菌感染的主要原因是医院病房中环境空气与床为主。

Objective To explore the risk factors of preventing bacterial infection and drug resistance in inpatients with ICU neurology.Microbiological analysis was carried out in the wards of the patients. Methods A total of 2 481 severe patients in ICU Department of Neurology,Xiangcheng County people's Hospital were selected for clinical monitoring and observation.In this study,pathology and microbiology were used to monitor and analyze the infected patients and their wards (air,bedclothes). Results Among the 2 481 patients,110 cases (4.43%) were infected,42 cases (38.18%) were multiple infection,76.92% of the total respiratory tract infections were found to be lower respiratory tract infections.Klebsiella pneumoniae and Pseudomonas aeruginosa were the main pathogens in the infected patients,and the proportion of the two pathogens was 44.08%.There were 3 cases of staphylococci in air and bedclothes and 1 case of Micrococcus vines in wards and bedsheets.Acinetobacter baumannii and Escherichia coli were also detected in the ward. Conclusion The presence of pathogenic bacteria in the ICU ward will lead to drug resistance in the course of medication and treatment.The main causes of the pathogen are air,microorganisms in bed sheets,patients with multiple infections and air.The distribution of microorganisms detected by bedspread products has the same characteristics,and the main cause of bacterial infection is the environment air and bed in hospital wards.