鲍氏不动杆菌医院感染流行病学调查及对策  

Epidemiological study of Acinetobacter baumanniiinfections and countermeasures

作　　者：胡美春 杨西宁 韦柳青 宋英娇 

机构地区：[1]广西民族医院医院感染管理科,广西南宁530001

出　　处：《中华医院感染学杂志》2013年第7期1523-1525,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院鲍氏不动杆菌医院感染流行现状,提出控制措施降低医院感染率。方法采用回顾性调查的方法,对2010年1月-12月发生医院感染的122例患者临床资料进行统计分析。结果不动杆菌属医院感染率为0.34%,例次感染率为0.41%;感染病例平均年龄为60.20岁,平均住院天数为39.17d;所调查的122例患者大多有严重的原发疾病,如心脑血管疾病、肿瘤、重型颅脑损伤等;感染科室分布以ICU和神经外科最常见,分别占29.51%和12.30%;感染涉及6个部位,其中下呼吸道占的比重最大,达74.29%,其次是伤口感染和泌尿道感染,分离的菌株主要来源于痰标本;共有36例为混合感染,其中30例合并有两种病原菌,6例有3种菌混合感染;122例感染病例,痊愈35例,好转70例,未愈18例,死亡17例,病死率为13.94%。结论医院鲍氏不动杆菌感染大多发生在住院时间长、有严重的基础疾病的老年患者,以ICU和神经外科较为突出;呼吸道和切口为主要的感染部位,混合感染比较常见;患者病死率较高。OBJECTIVE To investigate the prevalence of Acinetobacter baumannii infections in the hospital so as to put forward the control measures to reduce the incidence of nosocomial infections. METHODS By means of retrospective survey, the clinical data of 122 patients who suffered from the nosocomial infections from Jan to Dee were statistically analyzed. RESULTS The incidence rate and case-time rate of Acinetobacter infections were 0.34% and 0.41 %, respectively ; the average age of the patients with infections was 60.20 years old, the average hospitalization duration was 39.17 days. Of 122 patients invested, the majority was comp; izated with such severe primary diseases as cardiovascular and eerebrovascular diseases, tumor, and severe craniocerebral injury. The Acinetobacter baumannii infections mainly occurred in ICU （29.15 %） and neurosurgery department （ 12.30 %） Within the 6 involved infected sites, the lower respiratory tract has the highest incidence rate （74.29%）, and the subsequent sites were burn wound and upper respiratory tract. The isolated strains of Acinetobacter were mainly from sputum specimens. Totally 36 cases were with mixed infections, among which there were 30 cases with the infections caused by two species and 6 cases with the infections caused by 3 species. Of 122 cases of patients with infections, there were 35 cases cured, 70 cases improved, 18 cases without being cured, and 17 cases having died ,with the mortality of 13.94%. CONCLUSION The Acinetobacter infections mainly occur in the senile patients with severe underlying diseases and long hospital stay and mainly distribute in the ICU and the neurosurgery department. The respiratory tract and the incision are dominant in the infection sites . The mixed infections are very common. The mortality is high.

关 键 词：鲍氏不动杆菌 医院感染 流行病学 对策 

分 类 号：R181.32[医药卫生—流行病学]