骨科手术患者医院感染的调查分析  

Investigation and analysis on nosocomial infections in orthopaedic surgery patients

作　　者：吴颖娜[1] 方欢[1] 范晓玲[1] 曾宪铁[1] 

机构地区：[1]天津医院病案科,天津300211

出　　处：《中华医院感染学杂志》2014年第8期1960-1962,共3页Chinese Journal of Nosocomiology

基　　金：天津市卫生局科技基金资助项目(2012KZ054)

摘　　要：目的了解骨科手术患者医院感染情况,加强骨科手术患者医院感染的预防与控制,为医院感染监测工作提供数据支持,降低医院感染发生率。方法回顾性调查2008-2012年医院收治住院患者共69 760例,进行医院感染率、感染部位分布及病原菌的分离进行分析,采用SPSS 19.0统计软件包进行数据分析。结果 69 760例住院患者中骨科手术患者57 215例,占82.02%,发生医院感染1 576例,感染率2.75%,高于住院患者感染率的2.48%(P<0.001);感染1 675例次,例次感染率2.93%;感染部位前3位依次是手术切口感染882例次占52.65%、呼吸道感染513例次占30.62%、泌尿道感染211例次占12.59%;检出各类病原菌1 529株,以革兰阴性菌为主占58.86%,前5位分别为鲍氏不动杆菌263株占17.20%、肠球菌属200株占13.08%、金黄色葡萄球菌185株占12.10%、大肠埃希菌159株占10.40%、肺炎克雷伯153株占10.00%。结论骨科手术患者的医院感染率明显高于其他住院患者,应加强骨科手术患者医院感染的预防与控制工作,降低医院感染发生率。OBJECTIVE To explore the situation of nosocomial infections in orthopaedic surgery patients so as to strengthen infection control and prevention, provide clinical infection monitor data, and reduce infection occurence. METHODS A retrospective investigation was performed on the basis of 69760 hospitalized patients received and cured in 2008--2012. The nosocomial infection rate （NIR）, infection site distribution, and isolation rate of pathogenic bacteria were analyzed. SPSS 19.0 statistical software was used for data analysis. RESULTS Among 69760 cases of hospitalized patients, there were 57215 cases of orthopaedic surgery patients, accounting for 82. 02%, and 1576 cases of nosocomiaI infection occurred. NIR was 2.75%, which was higher than 2.48% in other hospitalized patients （P〈0. 001）. There were 1675 case-times of nosocomial infections, and the case-times of nosocomial infection rate was 2.93%. Top three infection sites were successively surgical incision （882 case- times of infection, 52.65 %）, respiratory tract （513 case-times of infection, 30.62 %） and urinary tract （211 case- times of infection, 12.59%）. 1529 strains of various types of pathogenic bacteria were detected. Gram-negative bacteria were isolated the most frequently （58.86 %）. Top five pathogenic bacteria were respectively Acinetobacter baumannii （263 strains, 17. 20%）, Enterococcus （200 strains, 13. 08%）, Staphylococcus aureus （185 strains, 12.10%）, Escherichia coli （159 strains, 10. 40%）, and Klebsiella pneumoniae （153 strains, 10. 00%）. CONCLUSION NIR in orthopaedic surgery patients was significantly higher than that in other hospitalized patients. In the future, the prevention and control works of nosocomial infection in orthopaedic surgery patients should be strengthened to reduce the incidence of nosoeomial infection.

关 键 词：骨科手术 住院患者 医院感染 

分 类 号：R181.32[医药卫生—流行病学]