心力衰竭患者医院感染特点与病原菌分析  

Features of nosocomial infections in heart failure patients and pathogenic analysis

作　　者：毛治尉[1] 王平[1] 郭攀[1] 孙漾丽[1] 

机构地区：[1]郑州大学附属郑州中心医院CCU,河南郑州450007

出　　处：《中华医院感染学杂志》2015年第12期2769-2771,共3页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅科技创新人才基金资助项目(114200580038)

摘　　要：目的：探讨心内重症监护病房（CC U ）心力衰竭患者医院感染病原菌分布特点，为降低其医院感染的发生及临床诊治提供参考。方法回顾性分析CCU 收治的104例发生医院感染心力衰竭患者（感染组）及同时期104例未发生医院感染的心力衰竭患者（未感染组）临床资料，调查其感染部位与病原菌分布。结果两组患者性别、基础疾病比较，差异无统计学意义；感染组患者年龄、心功能分级Ⅲ～Ⅳ级，血清白细胞介素‐6（IL‐6）、肿瘤坏死因子（TNF‐α）、血浆脑钠肽（BNP）水平均高于非感染组，两组比较差异均有统计学意义（P＜0．05）；104例心力衰竭感染患者共发生医院感染117例次，主要感染部位为呼吸道、泌尿道及皮肤黏膜，分别占58．12％、19．66％、9．40％；104例心力衰竭感染患者标本培养阳性76例，阳性率为73．08％；共培养出病原菌85株，其中革兰阴性菌56株、革兰阳性菌25株、真菌4株，分别占65．88％、29．41％、4．71％。结论 CC U心力衰竭患者病情严重、年龄大者更易发生医院感染，感染患者IL‐6、TNF‐α、BNP水平较未发生感染者增高，引起医院感染的病原菌以革兰阴性菌多见，感染部位以呼吸道为主。OBJECTIVE To investigate the distribution of pathogens in heart failure patients with nosocomial infections in CCU so as to decrease the occurrence of hospital infection and provide references for clinical diagnosis and treatment .METHODS The clinical data of 104 cases of heart failure patients being infected （infection group） and 104 cases of heart failure patients without hospital infections （uninfected group） in CCU were retrospectively analyzed .The infection sites and pathogenic distribution were all investigated .RESULTS No significant differences were found in the two groups of patients between genders and underlying diseases .The level of age ,heart function grading ,IL‐6 , TNF‐αand BNP in the infection group were higher than that of the uninfected group . The differences were significant （P〈0 .05） .Totally 117 cases of 104 patients were found nosocomial infections .The respiratory tract , urinary tract , skin and mucosa were found to be easily infected with the infection rate of 58 .12% ,19 .66% and 9 .40% respectively .All together 76 were detected to be bacteria positive and the rate was 73 .08% .There were 85 strains of pathogens were cultured ,including 56 strains of gram‐negative bacteria ,25 strains of gram‐positive bacteria and 4 strains of fungi ,accounting for 65 .88% ,29 .41% and 4 .71% respectively . CONCLUSION Heart failure patients with severe disease and older age are more prone to be infected in CCU .The level of IL‐6 ,TNF‐αand BNP in the infection group are higher than that of the uninfected group .Gram‐negative bacteria are the main factor causing nosocomial infections and respiratory tract infection is the most common to see .

关 键 词：心力衰竭 心内重症监护病房 医院感染 病原菌 

分 类 号：R181.32[医药卫生—流行病学]