产妇围产期医院感染临床特征与病原菌监测分析  

Clinical characteristics of perinatal nosocomial infections in puerpera and surveillance of pathogens

作　　者：袁琦文[1] 庄圆[1] 陈勇[1] 洪婷[1] 姜芳芳[1] 

机构地区：[1]珠海中山大学附属第五医院妇产科,广东珠海519000

出　　处：《中华医院感染学杂志》2015年第14期3314-3316,共3页Chinese Journal of Nosocomiology

基　　金：广东省医学科研基金资助项目(A2013855)

摘　　要：目的探讨妊娠期孕妇围产期医院感染临床特征及病原菌耐药性,为控制医院围产期感染提供依据。方法回顾性分析2011年11月-2013年11月医院分娩的1 800例产妇临床资料,统计医院感染发生率、感染部位、病原菌分布及对抗菌药物耐药率;采用SPSS 21.0统计软件进行分析。结果 1 800例产妇发生医院感染32例,感染率1.8%;医院感染主要发生部位为呼吸道8例占25.0%,手术切口6例占18.8%,会阴伤口5例占15.6%,泌尿道5例占15.6%;阴道手术产者医院感染发生率显著高于阴道自然分娩和剖宫产(P<0.05);32例医院感染患者分离出71株病原菌,其中革兰阳性菌27株占38.0%、革兰阴性菌41株占57.8%、真菌3株占4.2%;革兰阳性菌对万古霉素、利福平、利奈唑胺耐药率为0。结论妊娠期孕妇产后医院感染病原菌以革兰阴性菌为主,了解产妇医院感染临床特征及病原菌耐药率,并制定预防措施降低产妇医院感染率,从而提高产妇及新生儿预后。OBJECTIVE To explore the clinical characteristics of perinatal nosocomial infections in pregnant women during the pregnancy and analyze the drug resistance of pathogens so as to provide guidance for control of the perinatal infections.METHODS The clinical data of 1 800 puerpera who gave birth in the hospital from Nov 2011 to Nov 2013 were retrospectively analyzed;the incidence of nosocomial infections,infection sites,distribution of pathogens,and drug resistance rates were statistically analyzed;the statistical analysis was performed with the use of SPSS21.0software.RESULTS The nosocomial infections occurred in 32 of 1 800 puerpera with the infection rate of 1.8%,of whom 25.0%（8cases）had respiratory tract infections,18.8%（6cases）had surgical incision infections,15.6%（5cases）had perineal wound infections,and 15.6%（5cases）had urinary tract infections.The incidence of nosocomial infections was significantly higher in the puerpera undergoing vaginal surgical procedures than in the puerpera undergoing natural vaginal delivery or cesarean section,furthermore（P〈0.05）.A total of71 stains of pathogens have been isolated from the 32 puerpera with nosocomial infections,including 27（38.0%）strains of gram-positive bacteria,41（57.8%）strains of gram-negative bacteria,and 3（4.2%）strains of fungi.The drug resistance rates of the gram-positive bacteria to vancomycin,rifampicin,and linezolid were 0.CONCLUSIONThe gram-negative bacteria are dominant among the pathogens causing the postpartum nosocomial infections in the pregnant women during the pregnancy.It is an effective way to understand the clinical characteristics of the nosocomial infections in the puerpera and the drug resistance rates of the pathogens and formulate the prevention measures so as to reduce the incidence of the nosocomial infections in the puerpera and improve the prognosis of the puerpera and neonates.

关 键 词：妊娠期 孕妇 医院感染 围产期 病原菌 

分 类 号：R181.32[医药卫生—流行病学]