摘要
目的探讨冠心病患者急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后医院感染病原菌特点与相关因素。方法选择2012年3月-2017年4月于医院心导管室接受急诊PCI治疗的患者782例为研究对象,采集急诊PCI术后发生医院感染患者感染部位的分泌物或血液样本,分析病原菌特点,详细记录患者年龄、性别、体重指数、合并高血压、糖尿病等相关基础疾病、营养状况等临床资料,归纳冠心病患者急诊PCI术后医院感染的相关因素。结果 782例急诊患者PCI治疗术后发生医院感染43例,感染率为5.50%,感染部位以呼吸道和泌尿道为主;43例发生医院感染的患者,共培养分离病原菌57株,其中革兰阳性菌32株占56.14%,革兰阴性菌21株占36.84%,真菌4株占7.02%;年龄、合并基础疾病、侵入性操作、支架植入数量、PCI时段及住院时间均是导致冠心病患者急诊PCI术后医院感染的相关因素(P<0.05)。结论导致冠心病患者急诊PCI术后医院感染的病原菌主要以革兰阳性菌为主,临床应依据病原菌特点和导致其发生感染的相关因素采取相关干预措施进行综合性干预,对于降低其医院感染的发生率和改善患者预后有着重要意义。
OBJECTIVE To investigate the characteristics and related factors of pathogens for nosocomial infection in patients with coronary heart disease after percutaneous coronary intervention（PCI）.METHODS A total of 782 patients with emergency PCI were enrolled in the heart catheterization department of the hospital from Mar. 2012 to Apr. 2017.The related secretions or blood samples of the infected areas of patients with nosocomial infection were collected and analyzed.The characteristics of pathogens were analyzed.The patients＇ clinical data such as age,gender,body mass index,combination with hypertension,diabetes and other related basic diseases,and nutritional status were recorded in detail,and the risk factors of nosocomial infection in patients with coronary heart disease after emergency PCI were summarized.RESULTS A total of 43 patients with nosocomial infection were infected in 78 patients with emergency PCI.The infection rate was 5.50%.The infection site was mainly respiratory tract,followed by urinary tract.From the 43 patients with nosocomial infection after PCI,57 strains of pathogens were isolated,in which 32 strains were gram-positive bacteria,accounting for 56.14%,21 strains were gram-negative bacteria,accounting for 36.84%,and 4 strains were fungi,accounting for 7.02%.The age of the patients,combined underlying diseases,related invasive operation,stent implantation,PCI duration and hospital stay were all independent risk factors for nosocomial infection after emergency PCI in patients with coronary artery disease（P〈0.05）.CONCLUSION The pathogens of nosocomial infection in patients with coronary artery disease were mainly gram-positive bacteria.The clinical intervention should be carried out according to the distribution characteristics of pathogens and related risk factors leading to infection,which would be of great significance for lowering the incidence of nosocomial infection and improve the prognosis of patients.
作者
温书敏
林德智
袁权
李刘菲
吕燕茹
WEN Shu-min;LIN De-zhi;YUAN Quan;LI Liu-fei;LYU Yan-ru(The First People＇s Hospital of Neijiang,Neijiang,Sichuan 641000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第20期3080-3083,共4页
Chinese Journal of Nosocomiology
基金
四川省卫生计生委科研基金资助项目(130187)
