外科重症监护病房术后感染

Post-operation Infection in Surgical ICU

目的 为了解肿瘤外科术后患者医院感染分布及危险因素。方法 对我院外科重症监护病房 (SICU) 2 0 0 0年 9月～ 2 0 0 2年 8月收治的 936例术后患者进行统计 ,发现术后并发严重感染的 6 4例 (6 .83% ) ,对其病原菌进行检测和分析。结果 以G-杆菌居多占 38.8% ,以嗜麦芽寡养单胞菌、铜绿假单胞菌、鲍氏不动杆菌为主 ,其中嗜麦芽寡养单胞菌分离率超过铜绿假单胞菌 ;G+ 球菌占 2 9.3% ,有金黄色葡萄球菌、表皮葡萄球菌、人葡萄球菌、耳葡萄球菌等 ,其中金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌 (MRSA)占 96 .2 %。真菌占 31 8% ,白色念珠菌为主占 5 0 %。结论 机械通气、侵入性治疗、术前放化疗、术前合并症及术后外科并发症是引起感染的危险因素。

OBJECTIVE To know the distribution of nosocomial infection and the risk factors of post-operation infection in surgical ICU. METHODS From 936 post-operation patients investigated in our hospital ICU during Sep 2000-Aug 2002 were found 64 patients with serious infection. The pathogens were tested and analyzed. RESULTS The most prevalent pathogens of infection were G-negative bacteria (38.8%) including Stenotrophomonas maltophilia, Pseudomonas aeruginosa and Acinetobacter baumanii. Gram-positive bacteria accounted for 29.3%, which were Staphylococcus aureus, S.epidermidis, S.auricularis, etc, from S.aureus 96.2% were MRSA. Fungi accounted for 31.8% and from themCandida albicans were the major one(50%). CONCLUSIONS The risk factors of infection were mechanical ventilation, invasive treatment, radiotherapy-chemotherapy,complication and post-operation.