重症医学科脑科术后患者获得性肺炎感染情况及病原学分析  

The incidence and pathogen distribution of hospital acquired pneumonia in postoperative brain patients in ICU

作　　者：王浩渊[1] 陈晨[2] 陈敏珊[3] 许呢妹[1] 姚小红[1] 

机构地区：[1]江门市中心医院重症医学科,529030 [2]江门市中心医院肿瘤科,529030 [3]江门市中心医院院感科,529030

出　　处：《国际医药卫生导报》2015年第2期176-179,共4页International Medicine and Health Guidance News

基　　金：江门市科技汁划项目（2013032）

摘　　要：目的了解重症医学科脑科术后患者获得性肺炎的发病情况及相关病原学分布及动态变化，为医院院感工作提供依据。方法对江门市中心医院重症医学科2011年至2013年收治的363例脑科术后患者进行回顾性调查研究，获得性肺炎发病率及病原学研究严格采用卫生部2001年颁布的《医院感染诊断标准（试行）》及美国临床和实验室标准协会（NCCLS）最新标准进行，用WHONET5．5软件进行数据分析。结果3年期间脑科术后患者每年获得性肺炎发生率为60％左右，G^-菌（61．14％）仍是重症医学科院内感染的主要致病菌，铜绿假单胞菌最为常见，占G^-菌30．08％，而鲍曼不动杆菌检出比例逐年升高，2013年已上升成为和铜绿假单胞菌并列第一位的致病菌；G^＋菌中金黄色葡萄球菌最多见，占G^＋菌61．54％；真菌中念球菌（92．37％）最为多见，白似丝酵母菌呈逐年下降趋势，而非白念菌有逐年七升趋势。结论重症医学科脑科术后患者是发生院内下呼吸道感染的高危人群，而及时进行病原学检测，准确把握病原菌的动态变化，是有效控制院内感染的关键。Objective To investigate the incidence, pathogen distribution and dynamic changes of hospital acquired pneumonia （HAP） in brain patients after surgery in ICU, in order to provide the basis for nosocomial infection work. Methods Clinical data of 363 postoperative brain patients in our department from 2011 to 2013 were retrospectively reviewed. According to The Diagnostic Criteria for Hospital Infection （trial） issued by Ministry of Health （2001） and the criteria of guidelines of CLSI （2012）, the morbidity of HAP and pathogenic strains of sputum were analyzed. The results were analyzed with WHONET5.5 software. Results From 2011 to 2013, the incidence of HAP for postoperative brain patients in each year was about 60%. Gram-negative （G^-） bacteria were main pathogens of nosocomial infection in ICU （61.14%）; among them Pseudomonas aeruginosa was main pathogens （30.08%）, the detection ratio of Acinetobaeter baumannii increased year by year, Acinetobaeter baumannii had been the first pathogens as same as Pseudomonas aeruginosa in ICU in 2013. Among G^＋ bacteria, Staphylococcus aureus was the most common pathogens （61.54%）. Among fungus, Candida albicans was the most common pathogens （92.37%）, Candida albicans decreased year by year, while non-Candida albicans had a rising trend. Conclusion Postoperative brain patients in ICU have a high risk to get HAP. Timely pathogenic detection and mastering of dynamic pathogenic changes is the key to effectively control nosocomial infection.

关 键 词：重症医学科 脑科术后患者 获得性肺炎 病原学 

分 类 号：R563.1[医药卫生—呼吸系统]