某院神经外科医院病原菌感染的特征及危险因素分析

Pathogenic bacteria characteristics and risk factors of nosocomial infection of patients in Neurology and Neurosurgery in a hospital

目的分析本院神经外科医院感染的病原菌特征与感染影响因素,探讨医院感染的防治措施。方法采用回顾性分析法对2014年至2016年本院神经外科医院感染的病原菌特征以及影响因素等临床资料进行分析。结果共分离出382株病原菌,以革兰阴性菌为主,占68.59%(262/382),革兰阳性菌占29.58%(113/382),真菌占1.83%(7/382),其中,分布最广的4种病原菌为肺炎克雷伯菌(19.63%)、大肠埃希菌(14.40%)、金黄色葡萄球菌(14.40%)和鲍曼不动杆菌(13.61%)。革兰阴性菌对庆大霉素、头孢菌素类、氨苄西林、哌拉西林等普遍耐药。侵袭性治疗、广谱抗菌药物长期使用、入住ICU的时间和入院时患者感染指标增高可能是导致医院多病原菌混合感染的因素。结论本院神经外科多重耐药革兰阴性菌为主,侵袭性治疗、广谱抗菌药物长期使用、入住ICU的时间和入院时感染指标增高与医院多病原菌混合感染者预后密切相关。

Objective To analyze the pathogenic bacteria characteristics and risk factors for nosocomial infection of patients in Neurology and Neurosurgery in Hospital,and to investigate the prevention and cure measures for nosocomial infection.Methods The clinical data of pathogenic bacteria characteristics and the risk factors of iatrogenic infection of neurosurgery inpatients in our hospital from 2014 to 2016 were reviewed,retrospectively.Results Among the 382 strains of pathogens isolated,Gram-negative bacteria were predominant pathogens,accounting for 68.59%(262/382),Gram-positive cocci accounted for 29.58%(113/382),and fungi accounted for 1.83%(7/382),the 4 species of pathogens most widely distributed were Klebsiella pneumonia (19.63%),E.coli (14.40%),Staphylococcus aureus(14.40%) and Acinetobacter baumannii ( 13.61 %).Gram-positive cocci was resistant to gentamicin,cephalosporin,ampicillin,piperacillin,etc.Underlying diseases,invasive treatments,long-term and broad-spectrum antibiotic therapy,length of stay in ICU and high infection index may be the risk factors of the prognosis of patients with multi-pathoge infection.Conclusion Multi-drug resistant Gram-negative bacteria showed a trend of fashion in neurosurgery of our hospital.Underlying diseases,invasive treatments,long-term and broad-spectrum antibiotic therapy,length of stay in ICU and high infection index were closely related with the prognosis of patients with nosocomial multi-pathoge infection.