老年肿瘤患者医院感染调查分析  

Investigation of nosocomial infections in elderly tumor patients

作　　者：李清文[1] 黄丽红[1] 张俊[1] 陶红燕[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院感染管理科,湖北武汉430033

出　　处：《中华医院感染学杂志》2014年第10期2469-2471,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅基金资助项目(HW-2011B-029)

摘　　要：目的探讨2008-2013年医院老年肿瘤患者医院感染的病原菌分布,为临床诊治提供参考。方法回顾性分析2008年12月-2013年1月在医院治疗的1 684例老年肿瘤患者,对其中出现医院感染的患者进行病原菌分布调查。结果 1 684例老年肿瘤患者发生医院感染111例,感染率为6.59%;感染部位以下呼吸道感染最常见,51例占46.0%;共分离病原菌123株,其中革兰阴性菌78株占63.4%,以大肠埃希菌为主;革兰阳性菌31株占25.2%,以金黄色葡萄球菌为主;真菌14株占11.4%;抗菌药物使用率为54.9%,其中放疗和手术以预防性抗菌药物使用普遍,而化疗则以治疗性使用抗菌药物常见,在抗菌药物的联合应用上,放疗、化疗以一联使用为主,而手术则以二联使用为主,总体上仍以一联用药为主。结论老年肿瘤患者医院感染以下呼吸道感染为主,病原菌以大肠埃希菌、金黄色葡萄球菌、白色假丝酵母菌为主,要加强对抗菌药物的应用管理。OBJECTIVE To explore the distribution of pathogens causing nosocomial infections in the elderly tumor patients during 2008-2013 so as to provide guidance for the clinical diagnosis and treatment. METHODS A total of 1684 elderly tumor patients, who were treated in the hospital from Dec 2008 to Jan 2013, were enrolled in the study, then the distribution of the pathogens causing nosocomial infections was investigated. RESULTS Of the 1684 elderly tumor patients, the nosocomial infections occurred in 111 cases with the infection rate of 6.59%. There were 51 （46.0M） cases of lower respiratory tract infections. Totally 123 strains of pathogens have been isolated, including 78 （63.4%） strains of gram-negative bacteria, 31 （25.2%） strains of gram-positive bacteria, and 14 （ 11.4 %） strains of fungi; Escherichia coli was the predominant species of gram-negative＇bacteria, and the Staph- ylococcus aureus was dominant among the gram-positive bacteria. The utilization rate of antibiotics was 54.9%. The prophylactic antibiotics were widely used in radiotherapy and surgery, while therapeutic use of antibiotics was common in chemotherapy; on the basis of combination use of antibiotics, the one-drug medication was dominant in the chemotherapy and radiotherapy, however, the two-drug medication predominated in the surgery, and the one- drug medication remained dominant in general. CONCLUSION The lower respiratory tract infections are the most common in the elderly tumor patients. E. coli, S. aureus, and Candida albicans are the predominant species of pathogens. It is necessary to strengthen the administration of antibiotics.

关 键 词：老年患者 肿瘤 医院感染 临床诊治 

分 类 号：R181.32[医药卫生—流行病学]