食管癌术后医院感染特点与影响因素分析  

Analysis on characteristics and influencing factors of nosocomial infection after esophageal cancer operation

作　　者：姚静[1] 邢虎[1] 唐文玲[1] 张进[1] 陈潇君[1] YAO Jing;XING Hu;TANG Wen-ling;ZHANG Jing;CHEN Xiao-jun(Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001,China)

机构地区：[1]江苏大学附属医院,江苏镇江212001

出　　处：《中国消毒学杂志》2022年第4期286-289,共4页Chinese Journal of Disinfection

基　　金：江苏省医院协会医院管理创新研究课题(JSYGY-2-2019-13)。

摘　　要：目的 了解食管癌术后医院感染的特点,分析影响因素。方法 回顾性研究2017年1月—2018年12月在医院胸外科实施食管癌根治术患者的临床资料,对术后发生医院感染的相关影响因素进行单因素和多因素分析。结果 240例食管癌手术患者,发生医院感染81人次,感染92例次,例次感染率38.33%。主要感染部位为下呼吸道、胸膜腔和手术部位。共培养分离病原菌107株,其中革兰阴性菌73株,以鲍曼不动杆菌、肺炎克雷伯菌和大肠埃希菌为主;革兰阳性菌25株,以金黄色葡萄球菌和表皮葡萄球菌为主;真菌9株。多因素Logistic回归分析显示,年龄、术后带管进行呼吸支持、术后抗菌药物使用天数≥10 d、住院天数是患者术后发生医院感染的独立影响因素(P<0.05)。结论 食管癌患者术后医院感染常见部位为下呼吸道,感染病原菌以革兰阴性菌为主,多种因素与感染发生有关。Objective To investigate the characteristics of nosocomial infection after esophageal cancer surgery and related risk factors.Methods The clinical data of patients undergoing radical esophageal cancer surgery in the thoracic surgery department of the hospital from January 2017 to December 2018 were retrospectively collected. The factors related to the occurrence of nosocomial infection after operation were analyzed by single factor and multiple factors.Results In 240 patients undergoing esophageal cancer surgery, 81 hospital infections occurred, and 92 case infections occurred. The case infection rate was 38.33%. The main infection sites were the lower respiratory tract, pleural cavity and surgical site. 107 strains of pathogenic bacteria were isolated, of which 73 strains were Gram-negative bacteria, mainly Acinetobacter baumannii, Klebsiella pneumoniae, and Escherichia coli. 25 strains were Gram-positive bacteria, mainly Staphylococcus aureus and Staphylococcus epidermidis. 9 strains were fungi. Multivariate Logistic regression showed that age, postoperative respiratory support with a tube, postoperative days of antibacterial drug use, and hospitalization days were independent influencing factors of nosocomial infections(P<0.05).Conclusion The common site of nosocomial infection in patients with esophageal cancer is the lower respiratory tract, and the pathogenic bacteria are mainly Gram-negative bacteria. The occurrence of infection is related to many factors.

关 键 词：食管癌 医院感染 病原菌 影响因素 

分 类 号：R181[医药卫生—流行病学]