骨科住院患者阴沟肠杆菌感染的临床分析及控制研究  

Clinical analysis of Enterobacter cloacae orthopedic inpatients and control of infection

作　　者：魏淑菊[1] 冯阳[2] 周晓铭 李士光[1] 

机构地区：[1]莱芜市人民医院骨一科,山东莱芜271199 [2]莱芜市人民医院骨二科,山东莱芜271199 [3]山东省电力医院超声科,山东莱芜271500

出　　处：《中华医院感染学杂志》2014年第20期5102-5104,共3页Chinese Journal of Nosocomiology

基　　金：山东省卫生厅科研基金资助项目(莱科鉴字[2007]079)

摘　　要：目的探讨骨科住院患者阴沟肠杆菌感染危险因素,总结干预对策,以期提高临床治疗水平。方法选取2011年1月-2013年4月102例骨科住院患者为研究对象,对其中发生阴沟肠杆菌感染进行危险因素分析,并予以对症治疗,观察治疗后临床效果。结果 102例骨科住院患者发生阴沟肠杆菌感染11例,感染率10.78%;年龄、基础疾病、住院时间、无菌操作、抗菌药物应用、免疫抑制剂应用、皮肤或黏膜溃烂、侵入性操作、联合应用抗菌药物是骨科住院患者发生阴沟肠杆菌感染的单危险因素,也是独立危险因素(P<0.05);临床治疗后治愈率为45.46%、无效率为27.27%、总有效率为72.73%,C-反应蛋白、白细胞计数、重组人肿瘤坏死因子(TNF-α)、白介素-6(IL-6)在治疗3、7d后各项指标明显下降,治疗前后比较,差异有统计学意义(P<0.05)。结论规范化应用抗菌药物,结合对症处理,阴沟肠杆感染预后效果较为满意。OBJECTIVE To investigate the risk factors of Enterobacter cloacae infection of orthopedic inpatients and summarize intervention measures in order to improve the level of clinical treatment .METHODS Study objects were chosen from Jan .2011 to Apr .2013 ,which were 102 cases hospitalized orthopedic patients ,and the risk factors of these patients who took place on E .cloacae infection were analyzed ,then symptomatic treatment was given to them .So the clinical effect after treatment was observed .RESULTS There were 11 cases of E .cloacae inflection in 102 cases hospitalized orthopedic patients . The age , underlying disease , length of stay , aseptic operation , application of antimicrobial agents , application of immunosuppressive agents , skin or mucous membrane ulceration ,invasive operation , combined application of antimicrobial agents were the single risk factors of hospitalized patients infected with E .cloacae ,but also were the independent risk factors （P〈0 .05 ） .The cure rate after clinical treatment was 45 .46% ,ineffective rate was 27 .27% ,and total effective rate was 72 .73% .After the treatment of 3 ,7d of the C-reactive protein ,white blood cell count ,recombinant human tumor necrosis factor （TNF-α） , interleukin-6 （ IL-6 ） , the indicators decreased significantly （ P 〈 0 .05 ） . CONCLUSION The standardized using of antimicrobial drugs ,combined with symptomatic treatment ,and prognosis effect of E .cloa-cae infections are satisfactory .

关 键 词：阴沟肠杆菌 感染 骨科患者 危险因素 干预对策 

分 类 号：R181.32[医药卫生—流行病学]