重型颅脑损伤患者医院感染临床分析研究  

Clinical analysis of nosocomial infections in patients with severe craniocerebral injuries

作　　者：周华苏[1] 孔成[1] 戴红燕[1] 蒋云芬[1] 胡晓燕[2] 

机构地区：[1]浙江省磐安县人民医院脑科,浙江磐安县322300 [2]浙江省磐安县人民医院医院检验科,浙江磐安县322300

出　　处：《中华医院感染学杂志》2015年第9期2066-2068,共3页Chinese Journal of Nosocomiology

基　　金：浙江省科技局基金资助项目(2009ZYC-A55)

摘　　要：目的探讨重型颅脑损伤患者合并医院感染临床特点,以降低颅脑损伤患者医院感染率。方法选取2011年1月-2013年12月收治的296例重型颅脑损伤患者为研究对象,对患者的临床资料进行回顾性分析,观察患者医院感染率、好发部位、病原菌种类、对预后的影响,并分析相关危险因素;采用SPSS17.0软件进行统计分析。结果在296例重型颅脑损伤患者中,108例发生医院感染,感染率为36.49%,感染部位以呼吸道、泌尿道、消化道感染为主,分别占47.22%、35.19%、12.04%;共分离出病原菌120株,其中革兰阴性菌63株占52.50%,以铜绿假单胞菌为主,革兰阳性菌47株占39.17%,以金黄色葡萄球菌为主,真菌10株占8.33%;革兰阴性菌中铜绿假单胞菌对大部分抗菌药物均显示耐药性,肺炎克雷伯菌对一般抗菌药物均有较好的敏感性,金黄色葡萄球菌对青霉素耐药性达100.00%,对其他抗菌药物敏感性较高;革兰阳性菌中金黄色葡萄球菌对青霉素耐药率达100.00%,对其他抗菌药物均有较好的敏感性,凝固酶阴性葡萄球菌对四环素、利福平有较高的敏感性,对其他抗菌药物耐药率较高;感染患者病死率显著高于非感染患者,两者比较差异有统计学意义(P<0.05)。结论对于重型颅脑损伤患者,其医院感染率、感染病死率均相对较高,临床医护人员应针对感染相关危险因素进行护理干预,以控制及降低医院感染的发生。OBJECTIVE To explore the clinical characteristics of the severe craniocerebral injuries patients compli‐cated with nosocomial infections so as to reduce the incidence of the nosocomial infections in the patients with se‐vere craniocerebral injuries .METHODS A total of 296 patients with severe craniocerebral injuries who were treated in the hospital from Jan 2011 to Dec 2013 were recruited as the study objects ,then the clinical data of the patients were retrospectively analyzed ,the incidence of nosocomial infections ,predilection sites ,distribution of pathogens , and impact on the prognosis were observed ,the related risk factors were analyzed ,and the statistical analysis was performed with the use of SPSS17 .0 software .RESULTS The nosocomial infections occurred in 108 of 296 severe craniocerebral injuries with the infection rate of 36 .49% ,of whom 47 .22% had respiratory tract infections , 35 .19% had urinary tract infections ,and 12 .04% had gastrointestinal tract infections .Totally 120 strains of pathogens have been isolated ,including 63 （52 .50% ） strains of gram‐negative bacteria ,47 （39 .17% ） strains of gram‐positive bacteria ,and 10 （8 .33% ） strains of fungi;the Pseudomonas aeruginosa was the predominant spe‐cies of gram‐negative bacteria;the Staphylococcus aureus was dominant among the gram‐positive bacteria .The P . aeruginosa strains showed resistance to most of the antibiotics ,the K lebsiella pneumoniae strains were highly susceptible to the commonly used antibiotics ,the drug resistance rate of the S .aureus strains to penicillin was as high as 100 .00% ,and the strains were highly susceptible to other antibiotics .Among the gram‐positive bacteria , the drug resistance rate of the S .aureus strains to penicillin was as high as 100 .00% ,and the strains were highly susceptible to other antibiotics;the coagulase‐negative Staphylococcus strains were highly susceptible to tetracy‐cline and rifampicin ,and the strains were highly resistant to other antibiotics .The

关 键 词：颅脑损伤 医院感染 临床分析 

分 类 号：R181.32[医药卫生—流行病学]