摘要
目的探讨外科手术部位感染的发生率、常见致病菌谱及其耐药性,并分析手术部位感染发生率与手卫生产品消耗量之间的统计学相关性。方法回顾性分析2015年南京鼓楼医院与南京军区南京总医院诊治的外科手术病人资料,遴选出发生手术部位感染的研究人群,分析并总结其手术部位感染相关资料,并针对各科室手术部位感染发生率与该科室手卫生产品消耗量进行相关性分析及多元回归分析。结果在30 678例外科手术中,共307例发生手术部位感染,总体发生率为1.00%;不同科室的手术部位感染发生率存在较大差异,以普通外科最高(2.14%)、神经外科最低(0.14%);手术部位感染常见致病菌包括大肠埃希菌(35.8%)、金黄色葡萄球菌(13.20%)、粪肠球菌(7.84%)、铜绿假单胞菌(5.89%)、肺炎克雷伯菌(4.90%)等。相应病原菌的耐药率存在较大差异。外科各科室的手术部位感染发生率与三种手卫生产品消耗量均呈显著负相关(r=-0.83^-0.88、P=0.0031~0.0083);多元回归分析进一步显示:免洗手消毒液使用量显著影响手术部位感染发生率(P=0.023)。结论手卫生是影响手术部位感染发生率的关键因素,推动医务人员手卫生依从性或有助于减少手术部位感染。了解手术部位感染临床特征有助于制定个体化、区域性手术部位感染防治策略。
Objective To investigate the incidence of surgical site infection,summarize the microbial profiles and corresponding antimicrobial resistance, and analyze the correlation between the incidence of surgical site infection and the consumption of hand-hygiene products. Methods The clinical data of all patients that received surgical procedures in 2015 in Nanjing Drum Tower Hospital and the General Hospital of Nanjing Military Command were collected retrospectively. The characteristics of surgical site infection were analyzed. Spearman correlation and multiple linear regression models were performed for correlation analysis. Results A total of 30 678 surgical procedures were performed in 2015. Among them,307 cases of surgical site infection were identified with an overall incidence of 1.00%. General Surgery and Neurosurgery exhibited the highest and lowest incidence of surgical site infection, with 2.14% and 0.14% respectively. E. coli （35.8%）,S. aureus （13.2%）,E. faecalis （7.84%）,P. aeruginosa （5.89%） and K. pneumoniae （4.90%） were the most common pathogens of surgical site infection. Antimicrobial resistance profiles varied between different types of pathogens. A significant negative correlation was identified between consumption of hand-hygiene products and incidence of surgical site infection （r=-0.83^-0.88,P=0.0031~0.0083）. Furthermore, the consumption of hand sanitizer could significantly impact the incidence of surgical site infection among surgical patients （P=0.023）. Conclusion Hand hygiene is involved in the occurrence of surgical site infection. Promoting hand-hygiene compliance could probably decrease the incidence of surgical site infection. The characteristics of surgical site infection in current study could assist to tailor regional antimicrobial strategy in China.
出处
《中国实用外科杂志》
CSCD
北大核心
2017年第6期672-675,共4页
Chinese Journal of Practical Surgery
基金
国家自然科学基金(No.81602103)
江苏省基础研究计划(自然科学基金)(No.BK20160114)
南京市医学科技发展一般性课题(No.YKK16114)
中央高校基本科研业务费(No.021414380169)
黎介寿肠道屏障专项研究基金(No.LJS-201604)
关键词
手术部位感染
手卫生
医院获得性感染
病原学
surgical site infection
hand hygiene
nosocomial infection
microbial profiles
