妇科手术患者抗菌药物应用对肠道真菌感染的影响研究  

Antimicrobial application for intestinal fungus nosocomial infection in patients with gynecological surgery

作　　者：柴瑞芬 刘志敏 葛璐 陈静 孙宁 

机构地区：[1]濮阳市妇幼保健院妇科,河南濮阳457000 [2]濮阳市妇幼保健院产科,河南濮阳457000 [3]濮阳市妇幼保健院消毒供应中心,河南濮阳457000 [4]濮阳市妇幼保健院手术室,河南濮阳457000

出　　处：《中华医院感染学杂志》2016年第13期3086-3088,共3页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅基金资助项目(HN20130704)

摘　　要：目的探讨抗菌药物应用对妇科住院手术患者肠道真菌感染发生的影响,为临床防治肠道真菌医院感染的发生提供参考依据。方法选取2011年1月-2015年8月妇科住院手术的2870例患者,均于围术期预防应用抗菌药物,观察应用不同抗菌药物对患者肠道真菌医院感染发生的影响,调查患者有无肠道真菌医院感染发生,并及时采集粪便送检,采用SPSS19.0软件对数据进行统计分析。结果术后27例发生肠道真菌医院感染,感染率为0.94%;共检出真菌29株,主要为白色假丝酵母菌、酵母菌属、热带假丝酵母菌及曲霉菌属,分别占48.27%、27.59%、17.24%及6.90%;抗菌药物应用>3d、应用种类>2类、血红蛋白水平≤110g/L及体质量指数≤18.5kg/m2时患者发生肠道真菌医院感染率均高于抗菌药物应用≤3d、应用种类≤2类、血红蛋白水平>110g/L及体质量指数>18.5kg/m2患者,差异有统计学意义(P<0.05)。结论白色假丝酵母菌是妇科住院手术患者肠道真菌医院感染常见病原菌,抗菌药物时间、多种类应用及体质营养状况较差时肠道真菌医院感染发生风险性明显增高。OBJECTIVE To evaluate the antibacterial drugs application and nutrition research on the influence of the intestinal fungus nosocomial infection patients with gynecological surgery in hospital,and to provide clinical prevention and treatment of intestinal fungus provide reference for the occurrence of iatrogenic infection.METHODSA total of 2 870 patients of gynecologic surgery in hospital from Jan.2011 to Aug.2011 were selected,and they were given antibiotics in the perioperative periods to prevent infections.The application and nutritional status of hospitalized patients with different antibiotics during the intestinal fungus iatrogenic infections were observed.Whether patients with intestinal fungal nosocomial infections was investigated,and stool inspection was timely carried out.The results were statistically analyzed by software SPSS19.0.RESULTSA total of 27 cases of postoperative intestinal fungus iatrogenic infection occurred with an infection rate of 0.94%.a total of 29 strains of fungi were detected,and they were mainly Candida albicans,Yeast,tropical Candida and Aspergillus with the constituent ratio of 48.27%,27.59%,17.24% and 6.90%respectively.When the conditions were controlled like these：time of antibacterial drugs application 〉3d,types of antibacterial drugs 〉2,hemoglobin level≤110g/L and body mass index ≤18.5kg/m^2,the infection rates of patients with intestinal fungus iatrogenic were all higher than that of these conditions：time of antibacterial drugs application≤3d,types of antibacterial drugs≤2,hemoglobin level 〉110 g/L and body mass index 〉18.5 kg/m^2.The difference was significant（P〈0.05）.CONCLUSION C.albicans are the common pathogenic bacteria in department of gynaecology surgery in patients with intestinal fungus nosocomial infection,and intestinal fungus significantly increased risk of iatrogenic infection with longer time for using antibacterial drugs,more types of antibacterial drugs and poor nutritional status.

关 键 词：抗菌药物 妇科 手术 肠道 真菌 医院感染 

分 类 号：R978.1[医药卫生—药品]