神经科ICU医院获得性感染病原菌及医院感染危险因素分析  

Risk factors of hospital-acquired infections caused by pathogens in neurological ICU

作　　者：姜继娜[1] 韩龙[2] 

机构地区：[1]齐齐哈尔医学院附属第三医院神经一科,黑龙江齐齐哈尔161000 [2]齐齐哈尔医学院附属第三医院口腔科,黑龙江齐齐哈尔161000

出　　处：《中华医院感染学杂志》2013年第15期3592-3593,3596,共3页Chinese Journal of Nosocomiology

摘　　要：目的研究神经科ICU患者医院感染的危险因素,病原菌的种类及耐药性,并探讨对神经科ICU患者护理方式,以降低患者医院感染的发病率并探寻有效的治疗医院感染的方法。方法回顾性分析近两年神经科ICU患者的感染状况,对病原菌的耐药性进行分析。结果神经科ICU感染的病原菌中,革兰阳性菌占35.0%,其中金黄色葡萄球菌、粪肠球菌、表皮葡萄球菌分别占16.3%、11.3%、7.5%;革兰阴性菌占65.0%,主要为鲍氏不动杆菌、肺炎克雷伯菌和铜绿假单胞菌为主,分别占27.5%、22.5%和15.0%;患者的年龄、住院时间、是否使用呼吸机、是否插尿管和是否气管切开等是神经科ICU患者医院感染的危险因素(P<0.05)。结论年龄偏大、住院时间长、使用呼吸机插管和气管切开的患者为神经科ICU医院感染的易感人群,若发生感染,首先检测病原菌种类,进行药敏试验,选择耐药率低的抗菌药物交叉使用,以降低耐药率。OBJECTIVE To study risk factors of nosocomial infections in the patients of neurological ICU, the species of pathogens, and the drug resistance and explore the nursing interventions so as to seek the effective treatment approaches to reduce the incidence of nosocomial infections. METHODS The incidence of the infections in the patients of neurological ICU during the past two years was retrospectively analyzed, and the drug resistance of the pathogens was analyzed. RESULTS Of the pathogens causing infections in the neurological ICU , the gram- positive bacteria accounted for 35.0%, among which the Acinetobacter baumannii （27.5%）, Klebsiella pneumon- iae （22.5%）, and Pseudomonas aeruginosa （15.0%） were the predominant species. The age, hospital stay, use of respirator, inserted catheter, and tracheal incision were the risk factors associated with the nosocomial infections in the patients of neurological ICU. CONCLUSION The patients with advanced age, long hospital stay, use of ventilator and catheterization, or tracheal incision are the populations at high risk of nosocomial infections in the neurological ICU. As the infections occur, the species of the pathogens should be identified at first , the drug susceptibility testing being performed. The sensitive antibiotics should be chosen for the cross use so as to reduce the drug resistarme rates.

关 键 词：神经科 重症监护病房 感染 病原菌 危险因素 

分 类 号：R181.32[医药卫生—流行病学]