抑郁症患者医院感染病原菌特点及相关因素分析  

Characteristics of pathogenic bacteria and related factors of nosocomial infections in patients with depression

作　　者：关义玲 符少剑 徐明雅[3] 许勤伟 王康恒 刘向来 

机构地区：[1]海南省安宁医院儿童康复科,海南海口570206 [2]海南省安宁医院医院感染办公室,海南海口570206 [3]海南省安宁医院医学心理科,海南海口570206 [4]海南省安宁医院精神病二科,海南海口570206 [5]海南省安宁医院精神病六科,海南海口570206 [6]海南省精神卫生研究所,海南海口570206

出　　处：《中华医院感染学杂志》2018年第4期518-521,共4页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(813248)

摘　　要：目的探讨抑郁症患者医院感染现状及感染的相关因素。方法选择2013年1月-2015年1月于医院接受治疗的198例抑郁症患者为研究对象,采集感染患者脓液、血液、尿液、痰液等标本进行细菌鉴定及药敏实验,并对抑郁症患者医院感染的相关因素进行分析。结果发生医院感染患者17例,感染率为8.59%。感染患者共培养分离病原菌20株,其中革兰阳性菌8株占40.00%,革兰阴性菌11株占55.00%,真菌1株占5.00%。药敏结果显示,主要革兰阳性菌对青霉素G、红霉素的耐药率较高,而对万古霉素、利奈唑胺较敏感;主要革兰阴性菌对氨苄西林耐药率较高,对头孢哌酮/舒巴坦、亚胺培南、美罗培南较敏感;铜绿假单胞菌及肺炎克雷伯菌对左氧氟沙星较敏感。年龄≥60岁、合并基础病、住院时间≥25d、广谱抗菌药物使用、侵入性操作、无预防感染意识、医院感染管理制度不完善、抑郁程度较重、使用两种及以上抗抑郁药物是抑郁症患者院内感染的相关因素(P<0.05)。结论抑郁症患者医院感染病原菌以革兰阴性菌为主,引起医院感染的相关因素较多,应根据相关因素采取相应措施,以降低抑郁症患者医院感染的发生率。OBJECTIVE To investigate the status of nosocomial infections and the related factors of infections in patients with depression.METHODS A total of 198 patients with depression treated in hospital from Jan.2013 to Jan.2015 were selected as the research objects.Specimens of pus,blood,urine and sputum were collected for bacterial identification and drug sensitivity tests,and related factors of nosocomial infections in patients with depression were analyzed.RESULTS There were 17 cases of nosocomial infections,and the infection rate was 8.59%.Totally20 strains of pathogenic bacteria were isolated from infected patients,of which 8 strains were gram-positive bacteria accounting for 40.00%,11 strains were gram-negative bacteria accounting for 55.00%,and 1 strain was fungi accounting for 5.00%.Drug susceptibility tests results showed that main gram-positive bacteria were highly resistant to penicillin G and erythromycin,and more sensitive to vancomycin and linezolid,and main gram-negative bacteria had high resistant rate to ampicillin,and were susceptible to cefoperazone/sulbactam,imipenem and meropenem.Pseudomonas aeruginosa and Klebsiella pneumoniae were sensitive to levofloxacin.Age≥60 years old,with underlying diseases,length of stay ≥25 d,broad-spectrum antimicrobial drug use,invasive procedures,no awareness of prevention of infection,imperfect nosocomial infection management system,more severe depression,and use of 2 or more antidepressants were related factors for nosocomial infections in patients with depression（P〈0.05）.CONCLUSION Gram-negative bacteria are the main pathogens of nosocomial infections in depressive patients.There are many factors that cause nosocomial infections.Corresponding measures should be taken according to relevant factors to reduce the incidence of nosocomial infections in depressive patients.

关 键 词：抑郁症 医院感染 病原菌 相关因素 

分 类 号：R378[医药卫生—病原生物学]