口腔颌面肿瘤患者术后医院感染的病原菌分析与控制  

Analysis on pathogenic bacterial species and prevention measures of postoperative nosocomial infections in patients with oral and maxillofacial tumors

作　　者：丁国强[1] 蒋红卫[1] 叶英响[2] 王芬[1] 徐春燕[1] 

机构地区：[1]义乌市中心医院口腔科,浙江义乌322000 [2]义乌市中心医院药剂科,浙江义乌322000

出　　处：《中华医院感染学杂志》2015年第4期807-809,共3页Chinese Journal of Nosocomiology

基　　金：浙江温州市科技局社会发展基金资助项目(y20130245)

摘　　要：目的探讨口腔颌面肿瘤患者术后医院感染的病原菌分析及预防治疗措施,为降低医院感染率提供依据。方法收集2009年7月-2013年9月600例行手术治疗的口腔颌面肿瘤患者临床资料,记录患者医院感染率及部位分布,并对病原菌种类、耐药性进行分析。结果 600例患者中发生医院感染30例,感染率5.0%;主要感染部位为手术创面占53.33%,其次为呼吸道感染占33.33%;年龄≥60岁、住院≥5周的患者医院感染率显著高于同组其他患者,差异有统计学意义(P<0.05);医院感染患者中共检出病原菌53株,其中革兰阳性菌34株占64.15%、革兰阴性菌19株占35.85%;革兰阳性菌对常用抗菌药物耐药率较高,对万古霉素、左氧氟沙星耐药率较低,革兰阴性菌对常用抗菌药物的耐药率均已>40.0%。结论口腔颌面肿瘤患者术后医院感染的病原菌主要是革兰阳性菌,医院感染与住院时间、年龄有关。OBJECTIVE To explore the pathogenic bacterial species and prevention measures of postoperative nosocomial infections in patients with oral and maxillofacial tumors so as to reduce nosocomial infection rate.METHODS Clinical data of 600 cases of patients with oral and maxillofacial tumors treated in our hospital were collected,the infection rate and the infection locations of patients were recorded,and the pathogenic bacterial species and bacterial drug resistance were analyzed.RESULTSIn 600 patients,30cases of infections occurred,the infection rate was 5.0%.The main infection sites were surgical wounds（53.33%）,followed by respiratory tract（33.33%）.The nosocomial infection rate in patients with age≥60years and hospitalization time≥5weeks was significantly higher than in other patients（P〈0.05）.Totally 53 strains of pathogenic bacteria were detected in the patients with nosocomial infections,including 34 strains of gram positive bacteria（64.15%）,19 strains of gram negative bacteria（35.85%）.The resistance rate to vancomycin and levofloxacin was low,while the resistance rates of the gram-ngeative bacteria to the commonly used antimicrobial drugs were more than 40.0%.CONCLUSIONThe main pathogenic bacterial species of nosocomial infections in patients with oral and maxillofacial tumors are mainly gram positive bacteria,the incidence rate of nosocomial infection is related to hospitalization time and age.

关 键 词：口腔颌面 肿瘤患者 病原菌 医院感染 

分 类 号：R378[医药卫生—病原生物学]