泌尿外科医院感染危险因素与病原菌耐药分析  

Risk factors for nosocomial infections in department of urology and characteristics of pathogens

作　　者：杨瑜[1] 陈明[1] 朱伟东[1] 沙国柱[1] 柳靖[1] 陈恕求[1] 张晓文[1] 许斌[1] 姜华[1] 刘宁[1] 王奕铎[1] 

机构地区：[1]东南大学附属中大医院泌尿外科,江苏南京210009

出　　处：《中华医院感染学杂志》2016年第1期120-122,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81300472)

摘　　要：目的探讨泌尿外科医院感染危险因素及病原菌耐药特征,为降低医院感染率提供依据。方法回顾性分析2012年5月-2015年5月医院泌尿外科收治的852例住院患者临床资料,分析医院感染率、感染部位及病原菌耐药特征;采用非条件多因素logistic回归方程分析医院感染的独立危险因素;采用SPSS19.0软件对数据进行统计分析。结果 852例患者发生医院感染33例,医院感染率3.9%;其中呼吸系统感染13例占39.4%,泌尿道感染8例占24.2%,手术切口感染5例占15.2%;33例医院感染患者共分离出43株病原菌,其中革兰阳性菌10株占23.3%,革兰阴性菌30株占69.8%,真菌3株占6.9%;金黄色葡萄球菌对万古霉素耐药率为16.7%,对利福平耐药率为0,表皮葡萄球菌对利福平、万古霉素耐药率均为0;呋喃妥因、亚胺培南对革兰阴性菌的敏感性较高;年龄≥60岁、基础疾病、住院时间≥5d是导致医院感染的独立危险因素。结论泌尿外科医院感染病原菌主要是革兰阴性菌,医院感染应以预防为主,针对医院感染的危险因素,制定针对性的预防措施,从而降低医院感染率。OBJECTIVE To explore the risk factors for nosocomial infections in the department of urology and observe the characteristics of drug resistance of pathogens so as to reduce the incidence of nosocomial infections.METHODS The clinical data of 852 patients who were hospitalized the department of urology from May 2012 to May 2015 were retrospectively analyzed,the incidence of the nosocomial infections,infection sites,and characteristics of drug resistance of the pathogens were observed,the non-conditional multivariate logistic regression analysis was carried out for the independent risk factors for the nosocomial infections,and the statistical analysis of data was performed with the use of SPSS19.0software.RESULTS Of 852 patients,33had the nosocomial infections with the infection rate of 3.9%,of whom 13（39.4%）had respiratory system infections,8（24.2%）had urinary tract infections,and 5（15.2%）had surgical incision infections.A total of 43 strains of pathogens were isolated from 33 patients with nosocomial infections,including 10（23.3%）strains of gram-positive bacteria,30（69.8%）strains of gram-negative bacteria,and 3（6.9%）strains of fungi.The drug resistance rate of the Staphylococcus aureus to vancomycin was 16.7%,and the drug resistance rate to rifampicin was 0.The drug resistance rates of the Staphylococcus epidermidis to rifampicin and vancomycin were 0.The gram-negative bacteria were highly susceptible to nitrofurantoin and imipenem.The independent risk factors for the nosocomial infections included the no less than 60 years of age,underlying disease,and hospitalization duration no less than 5days.CONCLUSIONThe gram-negative bacteria are dominant among the pathogens causing the nosocomial infections in the department of urology.It is necessary for the hospital to take the prevention measures aiming at the risk factors for the nosocomial infections and formulate targeted prevention measures so as to reduce the incidence of the nosocomial infections.

关 键 词：泌尿外科 医院感染 危险因素 病原菌 耐药特征 

分 类 号：R378[医药卫生—病原生物学]