胸腔闭式引流术后院内感染病原菌分布及预防对策研究  

Distribution of pathogens causing nosocomial infections after thoracic drainage and prevention countermeasures

作　　者：张蕾[1] 于红[1] 李明新[1] 王欣[1] 赵红[1] 

机构地区：[1]天津医院创伤上肢一病区,天津300211

出　　处：《中华医院感染学杂志》2017年第21期4935-4937,共3页Chinese Journal of Nosocomiology

基　　金：国家科技支撑计划基金资助项目(2008BAI52B03)

摘　　要：目的探究胸腔闭式引流术后院内感染病原菌分布及相应的预防对策,为合理用药提供指导。方法选择2013年5月-2015年5月医院收治的80例行胸腔闭式引流术后发生感染的患者,分析感染患者病原菌分布,观察主要细菌的耐药性,同时总结预防患者感染的护理措施。结果 80例行胸腔闭式引流术后发生感染的患者痰液标本中共分离出病原菌110株,其中革兰阴性菌60株,占54.55%,革兰阳性菌40株,占36.36%,真菌10株,占9.09%;药敏结果显示,肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌、金黄色葡萄球菌及肺炎链球菌对亚胺培南、美罗培南及万古霉素的耐药率为0%,敏感性均较高,其中,肺炎克雷伯菌、大肠埃希菌及鲍氏不动杆菌对哌拉西林、阿莫西林的耐药率均>50%,而金黄色葡萄球菌、肺炎链球菌对哌拉西林、阿莫西林、头孢唑林、庆大霉素以及青霉素的耐药性均>50%。结论行胸腔闭式引流术后发生感染的患者需合理使用抗菌药物,对行胸腔闭式引流术的患者采取有效的预防护理措施,能够有效降低感染率。OBJECTIVE To explore the distribution of pathogens causing nosocomial infections after thoracic drainage and put forward the corresponding prevention countermeasure so as to provide guidance for reasonable use of antibiotics.METHODS A total of 80 patients who underwent the closed thoracic drainage and had postoperative nosocomial infections in the hospital from May 2013 to May 2015 were enrolled in the study,the distribution of the pathogens isolated from the patients with infection was analyzed,the drug resistance of major species of pathogens was observed,and the prevention countermeasures were put forward.RESULTS Totally 110 strains of pathogens were isolated from sputum specimens of the 80 patients with postoperative nosocomial infections,of which 60（54.55%）were gram-negative bacteria,40（36.36%）were gram-positive bacteria,and 10（9.09%）were fungi.The result of the drug susceptibility testing showed that the drug resistance rates of Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii,Staphylococcus aureus and Streptococcus pneumoniae to imipenem,meropenem and vancomycin were 0%,the drug resistance rates of K.pneumoniae,E.coli and A.baumannii to piperacillin and amoxacillin were more than 50%,however,the drug resistance rates of S.pneumoniae and S.aureus to piperacillin,amoxacillin,cefazolin,gentamicin and penicillin were more than 50%.CONCLUSIONIt is necessary for the patients who have nosocomial infections after closed thoracic drainage to reasonably use antibiotics and take effective prevention measures for the patients who undergo the closed thoracic drainage so as to reduce the incidence of nosocomial infections.

关 键 词：胸腔闭式引流术 院内感染 病原菌分布 预防对策 

分 类 号：R619.3[医药卫生—外科学]