脑梗死患者医院感染病原菌分布与预防对策  

Distribution and prevention countermeasure of pathogens in cerebral infarction patients with nosocomial infections

作　　者：傅秋燕[1] 胡玲琳[2] 张梅[1] 黄燕华[1] 来青[1] 

机构地区：[1]杭州市第一人民医院神经内科,浙江杭州310000 [2]杭州市第一人民医院ICU,浙江杭州310000

出　　处：《中华医院感染学杂志》2014年第3期568-570,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医学会临床科研基金项目(2009ZYF18)

摘　　要：目的探讨脑梗死患者医院感染病原菌的分布特点及预防对策,并观察危险因素,旨在为临床预防医院感染提供指导依据。方法观察2010年1月-2012年6月住院治疗的1 210例脑梗死患者,其中310例住院期间发生医院感染,对患者留取痰液、尿液、血液等标本进行细菌培养及药物敏感试验,并对检测结果进行分析。结果 1 210例脑梗死患者发生医院感染310例,感染率为25.62%;其中肺部感染182例、泌尿系感染87例,分别占58.71%、28.06%;共检出病原菌434株,以金黄色葡萄球菌、铜绿假单胞菌、表皮葡萄球菌和肺炎克雷伯最多,分别占31.10%、17.97%、16.13%、9.91%;医院感染危险因素与年龄≥70岁、气管插管≥6d、气管切开≥7d、留置尿管、深静脉置管、抗菌药物的应用时间、基础疾病及住院天数有关(P<0.05)。结论脑梗死患者可出现医院感染,对于感染患者应加强病原菌监测,同时进行有效地规范护理干预,对积极治疗有重要价值。OBJECTIVE To explore the distribution characteristics and prevention countermeasures of the pathogens in cerebral infarction patients with noscomial infection, and to observe the risk factors in order to provide guidance for clinical prevention of noscomial infections. METHODS A total of 1210 cerebral infarction cases were observed from Jan. 2010 to Jun. 2012 in our hospital, including 310 cases of nosocomiaI infection patients. The sputum, urine, blood specimens of the patients were retained for the bacterial culture and drug susceptibility test, and the results of the tests were analyzed. RESULTS The nosocomial infections occurred in 310 patients among 1210 cerebral infarction cases, with the infection rate of 25.62 G, of which 182 cases of pulmonary infection（58.71 %）, 87 cases of urinary tract infection（28. 06%）. 434 strains of pathogens were detected by cultivation, and the most common bacteria were Staphylococcus aureus （31. 10%）, S. epidermidis（17. 97%）, Pseudomonas aeruginosa （16.13 % ） and Klebsiella pneumonia （9.91 %）. The nosocomial infective rate was correlated with age≥70 years old, time of endotracheal intubation≥ 6 days, time of tracheotomy≥ 7 days, indwelling urinary, deep venous vascular application, application of antibiotics, underlying disease and hospitalization time （P 〈 0. 05 ）. CONCLUSION Nosocomial infection may occur in the patients of cerebral infarction, so the monitoring of pathogens should be strengthened and effective standard nursing interventions should be taken for the infected patients.

关 键 词：脑梗死 医院感染 病原菌 护理对策 

分 类 号：R378[医药卫生—病原生物学]