妇产科泛耐药铜绿假单胞菌所致院内感染的临床分析及护理对策研究  

Clinical Analysis of Nosocomial Infections Induced PDRPA in Gynecology-Obstetrics and Its Nursing Strategies

作　　者：朱寿萍 付玉梅[2] 杨晓仪[2] 梁惠芬[2] 

机构地区：[1]广州市增城区朱村街社区卫生服务中心,广州511370 [2]广州医学院荔湾医院检验科,广州510170

出　　处：《抗感染药学》2016年第3期515-518,共4页Anti-infection Pharmacy

基　　金：广东省科技计划项目(编号:2011B031800348);广东省医学科研基金项目(编号:A2011527)

摘　　要：目的:研究妇产科泛耐药铜绿假单胞菌(PDRPA)所致院内感染的原因及其护理对策。方法:采用回顾性分析法,分析2010年7月—2012年7月700例妇产科患者的临床资料,共发生PDRPA所致院内感染15例,其发生率为2.14%;研究PDRPA的感染特点及其对常用抗菌药物的耐药性,并探讨相关的护理对策。结果:收集到妇产科内感染铜绿假单胞菌92株,其中PDRPA 38株,分离率为41.30%;痰液标本感染率为最高(73.68%),其次为尿液10.53%与咽试子5.26%;伤口分泌物、血液、穿刺液及引流液感染率相对较低;对阿米卡星的耐药率为40.00%,其次哌拉西林为49.23%,头孢他啶为52.31%,头孢噻肟耐药率为86.15%;对左氧氟沙星的耐药率为81.54%、庆大霉素为78.46%;PDRPA所致院内感染的护理措施主要包括改善病房环境、加强对患者的基础护理质量、严格无菌操作、及时进行细菌检测、加强各种管道的消毒处理、医院感染知识的宣传教育、进行药敏试验、加强产褥期护理及营养支持。结论:应加强耐药性的检测,合理选用抗菌药物,积极采取有效护理措施,以减少耐药株的产生及传播。Objective： To study nursing strategies of pan-drug resistant pseudomonas aerugmosa （PDRPA） induced nosocomial infections in department of gynecology-obstetrics. Methods： The clinical data of 700 cases of puerperae ad- mitted between July 2010 and July 2012 were analyzed retrospectively. Nosocomial infection occurred in 15 cases and the incidence was 2.14%. The characteristics of PDRPA infection and drug resistance to commonly used antibacterial agents were studied, and the related nursing strategies were explored. Results ： 92 strains of pseudomonas aeruginosa in the department of gynecology and obstetrics were collected, in which 38 strains were PDRPA, and the isolation rate was 41.30%. The infection rate of sputum specimen was the highest （73.68%）, followed by urine （10.53%） and throat swabs （5.26%）. The infection rates of wound secretion, blood, puncture fluid and drainage liquid were relatively lower. The drug resistance to amikacin was the lowest （40.00%）, followed by piperacillin （49.23%） and ceftazidime （52.31%）. The drug resistance to ceibtaxime was the highest （86.15%）, followed by levofloxacin （81.54%） and gentamicin （78.46%）. The nursing strategies of PDRPA induced nosocomial infections mainly included improvement of ward environment, strengthening of basic nursing to patients, strict aseptic operation, timely detection of bacterial, strengthening of various ways of disinfection treatments, publicity and education of knowledge about hospital infection, drug sensitive test, strengthening of puerperium nursing and nutrition support. Conclusion： The detection of drug resistance should be strengthened, antibiotics should be used rationally, and nursing strategies should be taken actively to reduce the genera- tion and spread of resistant strains.

关 键 词：妇产科 泛耐药铜绿假单胞菌 PDRPA 院内感染 临床分析 护理对策 

分 类 号：R969.3[医药卫生—药理学]