心血管内科住院患者医院感染情况分析

Analysis of nosocomial infection in hospitalized patients in the Department of Cardiology

目的探讨心血管内科住院患者医院感染的情况,为医院感染的防治提供参考。方法回顾性分析2016年1~12月浙江省人民医院心血管内科住院患者医院感染的送检标本1881例,明确培养出病原菌的标本148例。统计感染标本来源分布、病原体种类分布、药敏结果。结果感染标本以痰液、血液、尿液为主,分别占60.1%、17.6%、9.5%,排名前7位的病原体依次为白色念珠菌(40.5%)、大肠埃希菌(8.8%)、肺炎克雷伯菌(7.4%)、热带念珠菌(7.4%)、铜绿假单胞菌(6.1%)、鲍曼不动杆菌(4.7%)、表皮葡萄球菌(4.1%),白色念珠菌对主要抗真菌药物均敏感,敏感率在66%以上,革兰阴性杆菌对庆大霉素、妥布霉素较敏感,敏感率在69%以上,表皮葡萄球菌对庆大霉素、利奈唑胺、万古霉素等较敏感,敏感率为100.0%。结论心血管内科住院患者医院感染有其特殊性,提高临床操作的规范性、合理使用抗生素、积极治疗原发病、加强营养支持治疗及考虑发生医院感染时尽早进行病原学检查并根据结果制定治疗方案十分重要。

Objective To explore the nosocomial infection in hospitalized patients in the Department of Cardiology and provide reference for the prevention and treatment of nosocomial infection.Methods 1881 cases of nosocomial infections in hospitalized patients in the Department of Cardiology from January to December 2016 were retrospectively analyzed and 148 specimens of pathogens were clearly cultured.The distribution of source of infection specimens,distribution of pathogen species,and drug susceptibility results were calculated.Results The infected specimens were mainly sputum,blood and urine,accounting for 60.1%,17.6%,and 9.5%,respectively.The top 7 pathogens were Candida albicans(40.5%),Escherichia coli(8.8%),Klebsiella pneumoniae(7.4%),Candida tropicalis(7.4%),Pseudomonas aeruginosa(6.1%),Acinetobacter baumannii(4.7%),and Staphylococcus epidermidis(4.1%).Candida albicans were sensitive to the main antifungal drugs,and the sensitivity rate was above 66%.Gram-negative bacilli were sensitive to gentamicin and tobramycin,and the sensitivity rate was above 69%.Staphylococcus epidermidis were sensitive to gentamicin,linezolid,vancomycin,and the sensitivity rate was 100.0%.Conclusion Inpatients in the Department of Cardiology have specificity in nosocomial infection.It's important to improve the standardization of clinical operation,rational use of antibiotics,active treatment of primary disease,strengthen nutritional support treatment and consider the pathogen examination as soon as possible in the occurrence of nosocomial infection and develop a treatment plan based on the results.