重型颅脑外伤患者术后医院感染的病原学分析  

Etiological analysis of postoperative nosocomial infections in patients with severe craniocerebral trauma

作　　者：王孝芳[1] 李剑[1] 宋光太[1] 郑逸华[2] 王伟华[2] 缪石友[3] 

机构地区：[1]江山市人民医院神经外科,浙江江山324100 [2]江山市人民医院呼吸内科,浙江江山324100 [3]江山市人民医院院感科,浙江江山324100

出　　处：《中华医院感染学杂志》2016年第7期1563-1565,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技基金资助项目(2011KYA166)

摘　　要：目的探讨神经外科重型脑外伤患者术后感染、病原菌及耐药性,并分析控制术后感染的对策,以减少多重感染。方法选取医院2006-2013年重型脑外伤手术患者219例,对发生感染的患者留取标本进行病原菌培养和鉴定,数据采用WHONET 5.4软件进行统计分析。结果 2006-2013年重型颅脑外伤手术患者219例,其中发生感染69例,感染率31.51%;69例感染患者共培养出257株病原菌,以革兰阴性菌为主,共195株占75.88%;主要革兰阴性菌对亚胺培南和头孢哌酮/舒巴坦的耐药率较低,均<20.00%。结论神经外科重型脑外伤术后患者医院感染的发生率较高,多为多药耐药菌感染,临床应采取措施控制感染的发生,发现患者有感染,应立即分离培养病原菌及耐药试验,后给予针对性治疗,避免发生多重感染。OBJECTIVE To explore the distribution and drug resistance of the pathogens causing postoperative infections in the patients with severe craniocerebral trauma and put forward the prevention countermeasures so as to reduce the incidence of multiple infections.METHODS A total of 219 patients with craniocerebral trauma who were treated in the hospital from 2006 to 2013were enrolled in the study,then the specimens were collected from the patients with infections for culture and identification of pathogens,and the statistical analysis was performed with the use of WHONET 5.4software.RESULTS Of 219 patients with severe craniocerebral trauma who were treated from 2006 to 2013,69 had infections,with the infection rate of 31.51%.Totally 257 strains of pathogens were cultured from the 69 patients with infections,of which 75.88%（195strains）were gram-negative bacteria.The drug resistance rates of the main gram-negative bacteria to imipenem and cefoperazone-sulbactam were less than 20.00%.CONCLUSIONThe incidence of postoperative nosocomial infections is high in the patients with severe craniocerebral trauma of neurosurgery department,and the multidrug-resistant bacteria are dominant among the pathogens.It is necessary for the hospital to take control measures,carry out the isolation and culture of pathogens for the patients with infections,and perform the drug susceptibility testing so as to conduct targeted treatment and prevent multiple infections.

关 键 词：重型颅脑外伤 感染 病原菌 耐药性 

分 类 号：R651.1[医药卫生—外科学]