ICU开放性胸外伤医院感染的相关因素及耐药性分析

Related factors for nosocomial infection in ICU patients with open chest trauma and drug resistance

目的探讨开放性胸外伤患者ICU期间医院感染的相关影响因素及耐药性分析,为预防及控制医院感染的发生提供依据。方法采用回顾性调查方法,选取2016年1月-2017年10月医院ICU收治的252例患者,分析其性别、年龄、合并症、侵入性操作、基础疾病、住院时间、感染情况、用药情况等。结果在252例患者中,发生医院感染的共有38例,感染率15.07%,其中4例患者在住院期间发生两次医院感染,感染42例次,例次率为16.66%。其中患者年龄、入ICU时间、气管插管、气管切开、机械通气时间(h)是发生医院感染的主要影响因素;导致医院感染的菌种对抗菌药物的耐药性主要表现为对头孢类和青霉素类的耐药性。结论开放性胸外伤患者为污染性损伤、年龄偏高、基础疾病多、住院时间较长是其发生医院感染的主要影响因素;对于已经感染的病人,应尽快明确感染病原菌,针对性准确用药。

OBJECTIVE To explore the influencing factors for nosocomial infection in the patients with open chest trauma during ICU stay and analyze the drug resistance so as to provide guidance for prevention and control of the nosocomial infection.METHODS By means of retrospective survey,totally 252 patients who were treated in ICUs from Jan 2016 to Oct 2017 were enrolled in the study,the clinical data of the patients,including gender,age,complications,invasive procedures,underlying diseass,length of hospital stay,prevalence of infection and use of antibiotics,were observed.RESULTS Of the 252 patients,38 had nosocomial infection,with the infection rate15.07%,4 of whom had nosocomial infection twice during the hospital stay,totally 42 case-times of patients had the infection,with the case-time infection rate 16.66%.The age,length of ICU stay,endotracheal intonation,tracheotomy and mechanical ventilation duration(h)were the major influencing factors for the nosocomial infection.The pathogens causing the nosocomial infection were mainly resistant to cephalosporins and penicillin.CONCLUSIONThe contaminated injury,old age,multiple underlying diseases and long length of hospital stay are the major influencing factors for the nosocomial infection in the patients with open chest trauma.It is necessary to identify the pathogens isolated from the patients with infection and conduct targeted drug therapy.