胸外科患者术后医院感染病原菌分布及药敏分析  

Distribution and drug susceptibility of pathogens causing postoperative nosocomial infections in patients of department of thoracic surgery

作　　者：彭丛兄[1] 彭根英[2] 吴旭辉[1] 王华富[3] 吴功志[1] 

机构地区：[1]丽水市人民医院胸心外科,浙江丽水323000 [2]丽水市人民医院院感科,浙江丽水323000 [3]丽水市人民医院药剂科,浙江丽水323000

出　　处：《中华医院感染学杂志》2014年第17期4208-4210,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医院可持续发展扬子江研究基金项目(2011ZHA-YZJ312)

摘　　要：目的观察胸外科患者术后医院感染的特点,分析病原菌的分布及药敏特征,关注患者血清中IL-6和IL-12的表达特点,以期为临床治疗提供帮助。方法收集医院432例胸外术后患者的临床资料,观察感染患者的感染率、病原菌分布及药敏特征,关注感染患者血清中IL-6、IL-12的表达特点;采用SAS6.12软件进行统计分析。结果 432例胸外术后患者中有62例患者发生医院感染,感染率为14.35%;共分离出病原菌78株,其中革兰阴性菌35株占44.9%,革兰阳性菌40株占51.3%,真菌3株占3.8%;主要病原菌依次为金黄色葡萄球菌、鲍氏不动杆菌、溶血葡萄球菌、铜绿假单胞菌,分别占28.2%、25.6%、20.5%、16.7%;金黄色葡萄球菌和溶血葡萄球菌对万古霉素高度敏感,耐药率均为0,鲍氏不动杆菌和铜绿假单胞菌对亚胺培南高度敏感,耐药率分别为5.00%和7.69%;真菌对氟康唑高度敏感,耐药率为0;有医院感染患者血清中IL-6和IL-12的表达明显高于无医院感染的患者,两者比较差异有统计学意义(P<0.01)。结论胸外科术后医院感染高发,感染患者血清中以IL-6、IL-12为代表的炎性因子变化明显;临床应加强医院感染的管理,对出现感染的患者,要进行分泌物的培养及药敏试验。OBJECTIVE To observe the characteristics of nosocomial infections in patients of department of thoracic surgery, analyze the distribution and drug susceptibility of pathogens, and pay attention to the characteristics of expression of serum IL-6 and IL-12 so as to provide guidance for clinical treatment. METHODS The clinical data were collected from 432 patients who underwent the thoracic surgery, then the incidence of infections, distribution of pathogens, and characteristics of drug susceptibility were observed, great attention was paid to the characteristics of expression of serum IL-6 and IL-12, and the statistical analysis was performed with the use of SAS6.12 software. RESULTS Of the 432 patients who underwent the thoracic surgery, the nosocomial infections occurred in 62 cases with the infection rate of 14.35%. A total of 78 strains of pathogens have been isolated, including 35 （44.9%） strains of gram-negative bacteria, 40 （51.3%） strains of gram-positive bacteria, and 3 （3.8%） strains of fungi; the Staphylococcus aureus , Acinetobacter baumannii , Staphylococcus haemol yticus , and Pseudomonas aeruginosa were the predominant species of pathogens, accounting for 28.2%, 25.6%, 20.5%, and 16.7%, respectively. The S. aureus and S. haemolyticus were highly susceptible to vancomycin, with the drug resistance rates of 0; the drug resistance rates of A. baumannii and P. aeruginosa to imipenem were 5.00% and 7.69%, respectively; the drug resistance rate of the fungi to fluconazole was 0. The positive rates of expression of serum IL- 6 and IL-12 were significantly higher in the patients with nosocomial infections than in the patients without nosoeomial infections, and there was significant difference between the two （P〈0.01）. CONCLUSION The incidence of postoperative nosocomial infections is high the patients undergoing thoracic surgery; the inflammatory factors, known as the serum IL-6 and IL-12, change remarkably. It is necessary for the clinician to strengthen the control of nosocomial infection

关 键 词：胸科手术 医院感染 病原菌 药敏 白介素-6 白介素-12 

分 类 号：R378[医药卫生—病原生物学]