某三级甲等综合性医院外科术后肺炎流行病学调查  

Epidemiological investigation on postoperative pneumonia in a tertiary first-class hospital

作　　者：周嘉祥 贾建侠[1] 赵秀莉[1] 赵艳春[1] 贾会学[1] 姚希[1] 胡美华[1] 张然[1] 钱晶京[1] 李六亿[1] ZHOU Jia-xiang;JIA Jian-xia;ZHAO Xiu-li;ZHAO Yan-chun;JIA Hui-xue;YAO Xi;HU Mei-hua;ZHANG Ran;QIAN Jing-jing;LI Liu-yi(Department of Healthcare -associated Infection Management and Disease Prevention and Control, Peking University First Hospital, Beijing 100034, China)

机构地区：[1]北京大学第一医院感染管理-疾病预防控制处,北京100034

出　　处：《中国感染控制杂志》2020年第5期451-456,共6页Chinese Journal of Infection Control

摘　　要：目的对术后肺炎患者三间分布和病原学进行描述,了解某三甲医院外科手术患者术后肺炎的特点,初步探寻术后肺炎发生的危险因素。方法采用描述流行病学分析该院2014—2018年手术患者术后肺炎发生情况。结果2014—2018年该院外科手术患者术后肺炎例次发病率为0.19%~0.25%,平均发病率为0.22%,病死率为17.62%。不同年份、季度、月份间术后肺炎发病率、病死率差异无统计学意义。心脏外科、神经外科、胸外科是该院术后肺炎发病率居前三位的科室。小于1岁婴儿术后肺炎发病率(1.36%)最高,30~39岁患者术后肺炎发病率(0.01%)最低,术后肺炎发病率随年龄增长出现先降低后增高的趋势。男性术后肺炎发病率高于女性(χ^2=52.37,P<0.001)。术后肺炎患者标本分离病原菌中76.52%(163/213)为革兰阴性菌,常见的是鲍曼不动杆菌(27.23%)、铜绿假单胞菌(14.55%)、肺炎克雷伯菌(12.21%),术后肺炎多重耐药菌检出率为30.99%(66/213)。结论该院术后肺炎发病率低,心脏外科、神经外科和胸外科是术后肺炎高发科室,婴儿、高龄患者、男性患者是术后肺炎的高危人群,术后肺炎主要病原菌是革兰阴性菌,且对抗菌药物耐药率高。Objective To describe the distribution and pathogen of postoperative pneumonia(POP)in patients,understand the characteristics of POP of surgical patients in a tertiary-first class hospital,and explore the risk factors for POP.Methods Occurrence of POP in surgical patients from 2014 to 2018 was analyzed with descriptive epidemiological method.Results From 2014 to 2018,case incidence of POP in this hospital was 0.19%-0.25%,with an average incidence of 0.22%and case fatality rate of 17.62%.There was no significant difference in incidence and case fatality rate of POP among different years,seasons,and months.Department of cardiac surgery,neurosurgery and thoracic surgery were the top three departments of POP incidence in this hospital.Incidence of POP was the highest in infants<1 years(1.36%)and lowest in patients of 30-39 years old(0.01%).Incidence of POP decreased firstly and then increased with age.Incidence of POP in male was higher than that of female(χ^2=52.37,P<0.001).76.52%(163/213)of isolated pathogens from patients with POP were Gram-negative bacteria,mainly Acinetobacter baumannii(27.23%),Pseudomonas aeruginosa(14.55%),and Klebsiella pneumoniae(12.21%),detection rate of multidrug-resistant organisms in POP was 30.99%(66/213).Conclusion Incidence of POP is low in this hospital,department of cardiac surgery,neurosurgery and thoracic surgery are with high incidence of POP.Infants,elderly patients and male patients are high risk population of POP,the main pathogens of POP are Gram-negative bacteria with high antimicrobial resistance rate.

关 键 词：术后肺炎 发病率 病死率 病原菌 多重耐药菌 

分 类 号：R181.32[医药卫生—流行病学]