Stanford A型主动脉夹层患者体外循环术后发生院内感染的病原菌分布及其耐药性分析  

Distribution and d rug resistance of nosocomial infections in patients with acute Stanford A aortic dissection after cardiopulm onary bypass

作　　者：苏晶晶[1] 杨慧[1] 胡光 陈月 刘宏宇[1] 迟超[1] SU Jing-jing;YANG Hui;HU Guang;CHEN Yue;LIU Hong-yu;CHI Chao(Cardiovascular Surgery, First Affiliated Hospital of Harbin Medical University, Harbin 150000, China)

机构地区：[1]哈尔滨医科大学附属第一医院心脏大血管外科,黑龙江省哈尔滨市150000

出　　处：《中国心血管病研究》2019年第8期755-758,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的调查StanfordA型主动脉夹层患者体外循环术后发生院内感染的情况及其耐药性.方法回顾性分析2015年1月至2018年10月期间哈尔滨医科大学附属第一医院心脏大血管外科收治的StanfordA型主动脉夹层患者术后的临床资料.结果共收集260例患者资料,52例患者发生术后院内感染.其中15例患者同时发生血液及呼吸道感染,1例患者同时发生血液、呼吸道及其他部位感染;共感染68例次,其中血液感染28例次,占比41.2%;呼吸道感染37例次,占比54.4%;其他部位感染3例次,占比4.4%.分离出革兰阳性菌18株,革兰阴性菌50株,真菌未见.结论StanfordA型主动脉夹层患者体外循环术后发生院内感染风险较高,多重耐药菌感染发生率较高,综合的预防措施及合理的抗菌素应用,可减少StanfordA型主动脉夹层患者体外循环术后院内感染的发生.Objective To investigate nosocomial infection and drug resistance in patients with Stanford A aortic dissection after cardiopulmonary bypass. Methods The clinical data of patients undergoing Stanford A aortic dissection from January 2015 to Octobor 2018 in the First Affiliated Hospital of Harbin Medical University were retrospectively analyzed. Results A total of 260 patients were collected, of which 52 had nosocomial infection. There were 68 cases of infection in total. Among them, 15 patients suffered from simultaneous infection of blood and respiratory tract;1 patients occurred infection of blood, respiratory tract and other parts, at the same time. 28 had blood infection, accounting for 41.2%;37 had respiratory infection, accounting for 54.4%;3 had other infection, accounting for 4.4%. Eighteen strains of Gram-positive bacteria and 50 strains o f Gram-negative bacteria were isolated, but no fungi were found. Conclusion The risk of nosocomial infection in patients with Stanford type A aortic dissection after cardiopulmonary bypass is higher and the incidence of multi-drug resistant bacterial infection is higher. Comprehensive preventive measures and rational use o f antibiotics can reduce the incidence of nosocomial infection in patients with Stanford A aortic dissection after cardiopulmonary bypass.

关 键 词：主动脉夹层 体外循环 院内感染 耐药性 

分 类 号：R654.2[医药卫生—外科学]