203例抑郁症患者医院感染的病原菌分布特征、耐药性及危险因素分析

Pathogens, Drug Resistance and Risk Factors of Nosocomial Infection in 203 Patients with Depression

目的:探讨203例抑郁症患者医院感染的病原菌和耐药性及其危险因素。方法:选取本院2020年4月—2021年10月收治的203例抑郁症患者,分析病原菌分布和耐药情况以及感染的危险因素。结果:203例患者发生医院感染22例,感染率10.84%;共分离病原菌31株,革兰氏阴性菌16株(51.61%),革兰氏阳性菌13株(41.94%);耐药性分析显示,铜绿假单胞菌、大肠埃希氏菌、肺炎克雷伯菌对头孢哌酮/舒巴坦、亚胺培南、美罗培南的耐药率均为0.00%,金黄色葡萄球菌、表皮葡萄球菌、屎肠球菌对万古霉素、利奈唑胺和呋喃妥因的耐药率均为0.00%;危险因素分析显示,年龄≥60岁、病程≥3年、重度抑郁、有基础疾病、住院时间≥30 d、保护性约束时间≥3 d、有侵入性操作、使用3种及以上抗抑郁药物、使用广谱抗菌药物是患者感染的独立危险因素(P<0.05)。结论:抑郁症患者医院感染发生率较高,主要为呼吸道和胃肠道感染,应根据耐药情况选择敏感性高的抗菌药物。引起医院感染的危险因素较多,应采取相应的预防措施,降低医院感染发生率。

Objective: To investigatethe pathogens, drug resistance and risk factors of nosocomial infection in 203 patients with depression. Methods: A total of 203 patients with depression treated in our hospital from April 2020 to October 2021 were selected. The distribution of pathogens, drug resistance of pathogens and the risk factors of infection were analyzed.Results: There were 22 cases of nosocomial infection in 203 patients, with an infection rate of 10.84%. A total of 31 strains of pathogens were isolated, including 16 strains of Gram-negative bacteria(51.61%) and 13 strains of Gram-positive bacteria(41.94%). Drug resistance analysis showed that the drug resistance rates of Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae to Cefoperazone/sulbactam, imipenem and meropenem were 0.00%, and the drug resistance rates of Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecium to vancomycin, linezolid and nitrofurantoin were 0.00%. Analysis of risk factors showed that age ≥ 60 years, disease course ≥ 3 years, severe depression, basic disease,hospitalization time ≥ 30 days, protective restraint time ≥ 3 days, invasive operation, use of three or more antidepressants,and use of broad-spectrum antibacterial drugs were independent risk factors of nosocomial infection in patients with depression(P<0.05). Conclusion: The incidence of hospital infection in patients with depression is high, mainly respiratory and gastrointestinal tract infections. High sensitivity antibiotics should be selected according to drug resistance. There are many risk factors that cause hospital infection. Corresponding preventive measures should be taken according to relevant risk factors to reduce the incidence of hospital infection.