摘要
目的探讨县级医院外科医院感染的部位、感染病原菌构成比及对常用抗菌药物的耐药性,为临床医师合理用药提供参考依据。方法回顾性调查统计外科住院患者的病历资料3993份;数据处理采用WHONET 5.4-5.5版本统计分析。结果调查3993例外科患者发生感染197例、345例次,感染率为4.9%、例次感染率为8.6%;外科医院感染的好发部位主要是手术切口、泌尿道、皮肤及黏膜、呼吸道,分别占25.5%、20.9%、20.0%、17.7%;检出病原菌213株,按分离率由高到低依次为铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌,分别占21.6%、15.8%、12.6%、11.7%;敏感率除肠杆菌科细菌对碳青霉烯类抗菌药物、铜绿假单胞菌对碳青霉烯类、金黄色葡萄球菌对糖肽类分别为100.0%、83.3%、100.0%以外,外科感染的主要病原菌对临床常用抗菌药物均产生了不同程度的耐药性;耐甲氧西林葡萄球菌阳性率为42.2%。结论护理部应采取切实有效的干预措施、配合临床医师、严密监测、力图延缓细菌耐药性增长速度,预防与控制医院感染暴发流行。
OBJECTIVE To approach the infection sites,constituent ratios of bacterial species and antimicrobial resistance of the pathogens causing surgical infections in county-level hospital so as to guide the reasonable clinical use of antibiotics.METHODS A total of 3993 pieces of medical records of the surgery department patients were retrospectively investigated,and the statistical analysis of the data was performed by WHONET 5.4-5.5 software.RESULTS Of totally 3993 patients investigated,the nosocomial infections occurred in 197 patients（345 case-times of patients） with the infection rate of 4.9% and the case-time infection rate of 8.6%.The predilection sites of nosocomial infection mainly included the surgical incision（25.5%）,urinary tract（20.9%）,skin and mucosa membrane（20.0%）,and respiratory tract（17.7%）.Among 213 strains of pathogens causing surgical infections,the isolation rates were from high to low as follows： Pseudomonas aeruginosa（21.6%）,Escherichia coli（15.8%）,Staphylococcus aureus（12.6%） and Klebsiella pneumoniae（11.7%）.The drug susceptibility testing results indicated that except for 100.0% of susceptibility rate of carbapenems antibiotics against Enterobacteriaceae,83.3% of carbapenems antibiotics against P.aeruginosa and 100.0% of glycopeptides antibiotics against S.aureus,the main pathogenic bacteria causing the surgical infections varied in the drug resistance to the commonly used antibiotics.The isolation rate of the methicillin-resistant Staphylococci（MRS） was 42.2%.CONCLUSION It is necessary for the nursing department to take effective interventions to assist the clinicians,to closely monitor and to slow down the increasing tendency of antimicrobial resistance so as to prevent and control the prevalence of nosocomial infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第9期2218-2220,共3页
Chinese Journal of Nosocomiology
关键词
外科
医院感染
耐药性
护理
干预
Surgery department
Nosocomial infection
Antimicrobial resistance
Nursing
Intervention
