神经内科重症监护病房患者医院感染的临床分析

Clinical analysis of patients with hospital infection in neurology intensive care unit

目的:探讨神经内科重症监护病房患者医院感染情况,以降低神经内科重症监护病房医院感染率。方法:2011年1月-2014年5月收治NICU医院感染患者40例,根据患者的感染部位收集患者的相应标本进行细菌培养,观察感染率。结果:发生褥疮1例(2.5%),发生细菌性痢疾2例(5.0%),发生上呼吸道感染8例(20.0%),发生泌尿道感染9例(22.5%),发生下呼吸道感染16例(40.0%),其他部位4例(10.0%)。本组40例患者共培养出细菌63株,其中G+杆菌17株(27.0%),其中粪肠球菌5株(7.9%)、表皮葡萄球菌4株(6.3%)、金黄色葡萄球菌7株(11.1%)、其他G+葡萄球菌1株(1.6%);G-杆菌40株(63.5%),其中大肠埃希杆菌3株(4.8%)、嗜麦芽寡养单胞杆菌5株(7.9%)、鲍氏不动杆菌6株(9.5%)、铜绿假单胞杆菌9株(14.3%)、肺炎克雷伯杆菌11株(17.5%)、其他G-杆菌6株(9.5%);真菌6株(9.5%)。G-杆菌对亚胺培南的耐药率最低,G+球菌对万古霉素、替考拉宁的耐药率较低,其次是利福平。结论:对于NICU患者要及时进行细菌培养和耐药实验,选择合理的抗生素,控制医院感染。

Objective:To explore the hospital infection of patients in neurology intensive care unit in order to reduce the hospital infection rate in the neurology intensive care unit.Methods:The corresponding specimens of 40 patients with hospital infection in NICU from January 2011 to May 2014 were collected for bacterial culture according to the patient''s infection site.We observed the infection rate.Results:1 case with bedsore occurred(2.5%); 2 cases with bacillary dysentery occurred(5.0%);8 cases had upper respiratory tract infection(20.0%);9 cases had urinary tract infection(22.5%);16 cases had lower respiratory tract infection(40.0%) and 4 cases had other infection(10.0%).A total of 63 strains of bacteria were cultivated in this group of 40 cases of patients and 17 strains of G + bacillus(27.0%) included 5 strains of enterococcus(7.9%),4 strains of staphylococcus epidermis(6.3%),7 strains of staphylococcus aureus(11.1%),1 strains of other G + staphylococcus(1.6%).40 strains of G- bacillus(63.5%) included 3 strains of escherichia coli(4.8% ),5 strains of eosinophilic malt oligotrophic bacillus(7.9% ),6 strains of bowman''s(9.5% ),9 strains of pscudomonasaemginosa(14.3% ),11 strains of klebsiella pneumoniae(17.5% ),6 strains of other G- bacillus(9.5% ).There were 6 strains of fungi(9.5%).G- bacillus had the lowest resistance to imipenem,and G+ bacillus had the lowest resistance to vancomycin and teicoplanin and followed by rifampin.Conclusion:The NICU patients should have bacterial culture timely and drug resistance experiment in order to select rational antibiotics and control hospital infection.