冠心病介入治疗医院感染发生率、病原菌分布及危险因素分析  

Incidence of nosocomial infection, distribution of pathogens and risk factors in coronary heart disease patients undergoing interventional therapy

作　　者：许艳丽[1] 张丹丹[1] 韩敏芳[1] 袁磊 XU Yan-li;ZHANG Dan-dan;HAN Min-fang;YUAN Lei(The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215006,China)

机构地区：[1]苏州大学附属第一医院心内科,江苏苏州215006

出　　处：《中华医院感染学杂志》2022年第6期890-893,共4页Chinese Journal of Nosocomiology

基　　金：江苏省社会发展面上基金资助项目(BE2021649)。

摘　　要：目的 探讨冠心病经皮冠状动脉介入治疗(PCI)医院感染患者病原菌分布及危险因素。方法 选取2015年1月-2018年12月于苏州大学附属第一医院心导管室接受PCI治疗合并医院感染患者43例为感染组,同期按照随机数法选取未合并医院感染患者133例为非感染组。采集PCI术后医院感染患者感染部位的生物样本,进行病原菌培养,收集潜在影响因素,分析术后医院感染的危险因素。结果 本研究中纳入的43例医院感染患者占同期全部急诊PCI治疗患者的4.97%,感染部位以呼吸道和泌尿系统为主;共培养分离病原菌58株,其中革兰阳性菌31株占53.45%,革兰阴性菌23株占39.66%,真菌4株占6.89%。对潜在影响因素进行回归分析,与术后医院感染风险增高相关的因素涉及:年龄因素(年龄大)、合并糖尿病、不同PCI干预时段(P<0.05)。结论引发冠心病患者PCI干预后医院感染的病原菌以革兰阳性菌为主,年龄、合并疾病及不同PCI干预时段是合并感染的危险因素。OBJECTIVE To explore the distribution of pathogens and risk factors for nosocomial infection in the coronary heart disease patients undergoing percutaneous coronary intervention(PCI). METHODS A total of 43 patients who received PCI and were complicated with nosocomial infection in cardiac catheterization room of the First Affiliated Hospital of Soochow University from Jan 2015 to Dec 2018 were assigned as the infection group, meanwhile, 133 patients who were not complicated with nosocomial infection were randomly chosen as the non-infection group. The specimens were collected from infection sites of the PCI patients with postoperative nosocomial infection so as to carry out culture of pathogens, the potential influencing factors were collected, and the risk factors for the postoperative nosocomial infection were observed. RESULTS The 43 patients with nosocomial infection who were included in the study accounted for 4.97% among all the patients undergoing emergency PCI during the same period;respiratory tract and urinary system were the major infection sites. Totally 58 strains of pathogens were isolated, 31(53.45%) of which were gram-positive bacteria, 23(39.66%) were gram-negative bacteria, and 4(6.89%) were fungi. The regression analysis of the potential influencing factors showed that the old age, complication with diabetes mellitus and period of PCI were associated with the increase of risk of postoperative nosocomial infection(P<0.05). CONCLUSION The gram-positive bacteria are dominant among the pathogens causing the nosocomial infection in the coronary heart disease patients after PCI. The age, complication with disease and period of PCI are the risk factors for the complication with infection.

关 键 词：冠心病 介入治疗 医院感染 病原菌 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]