2019年-2022年儿科、产科及妇科住院患者院内感染病原体分布及耐药性分析  

Pathogen Distribution and Drug Resistance of Nosocomial Infections in Pediatric,Obstetric and Gynecological Inpatients From 2019-2022

作　　者：张胜男[1] 吴岷岷 徐文君[1] 王洁[2] 杨力[1] 钟天鹰[3] ZHANG Shengnan;WU Minmin;XU Wenjun;WANG Jie;YANG Li;ZHONG Tianying(Infection Management Office,Maternity Hospital affiliated to Nanjing Medical University/Nanjing Women and Children’s Healthcare Hospital,Nanjing,Jiangsu,210004;Department of Personnel,Maternity Hospital affiliated to Nanjing Medical University/Nanjing Women and Children’s Healthcare Hospital,Nanjing,Jiangsu,210004;President’s Office,Maternity Hospital affiliated to Nanjing Medical University/Nanjing Women and Children’s Healthcare Hospital,Nanjing,Jiangsu,210004)

机构地区：[1]南京医科大学附属妇产医院、南京市妇幼保健院感染管理办公室,江苏南京210004 [2]南京医科大学附属妇产医院、南京市妇幼保健院人事处,江苏南京210004 [3]南京医科大学附属妇产医院、南京市妇幼保健院院长办公室,江苏南京210004

出　　处：《江苏卫生事业管理》2024年第2期216-221,共6页Jiangsu Health System Management

摘　　要：目的:积极开展儿科、产科和妇科院内感染病原体分布、耐药性的调查,对经验性治疗妇儿院内感染有重要意义,也为院内感染防控提供参考依据。方法:选取2019-2022年入住我院儿科、产科及妇科诊断为医院感染的患者作为研究对象,收集这3个科室院内感染率、感染部位等信息,参照《全国临床检验操作规程》中的方法进行细菌分离和鉴定,使用法国生物梅里埃公司VITEK-2Compact全自动细菌鉴定仪和珠海迪尔DL-96全自动细菌测定系统进行细菌鉴定和药敏试验,依据美国临床实验室标准化委员会(CLSI)标准判断结果。结果:2019-2022年纳入研究对象的227124例儿科、产科及妇科患者中,累计发生院内感染770例,院内感染发生率为0.34%。770例院内感染患者中,儿科以菌血症和胃肠道感染多见,分别占31.87%和26.02%;产科以男女性生殖道的其它感染和上呼吸道感染多见,分别占15.98%和14.79%;妇科以腹(盆)腔内组织和急性盆腔炎多见,分别占24.32%和23.94%。770例院内感染患者的临床标本共分离、培养出病原体458株,儿科以表皮葡萄球菌和肺炎克雷伯菌为主,分别占23.12%和20.10%;产科以大肠埃希菌和粪肠球菌为主,分别占23.33%和20.00%;妇科以大肠埃希菌为主,占53.25%。儿科肺炎克雷伯菌对亚胺培南和美罗培南无耐药,产科大肠埃希菌对亚胺培南和美罗培南无耐药,妇科大肠埃希菌对亚胺培南和美罗培南耐药率均为1.11%,儿科表皮葡萄球菌对万古霉素和利奈唑胺无耐药,产科和妇科粪肠球菌对万古霉素和利奈唑胺无耐药。结论:2019-2022年儿科、产科及妇科院内感染发生率为0.34%,我院儿科院内感染率(1.17%)高于产科(0.12%)和妇科(0.43%)。抗菌药物妇科应用率显著高于产科应用率,且非一联用药为主,这就导致妇科院内感染病原体的耐药率高于产科。积极监测儿科、产科和妇科院内感染情况,并及时分析、�Objectives:The investigation of pathogen distribution and drug resistance of nosocomial infection in pediatrics,obstetrics and gynecology is of great significance for the empirical treatment of nosocomial infection in women and children,and also provides a reference for the prevention and control of nosocomial infection.Methods:Patients admitted to the Department of Pediatrics,Obstetrics and Gynecology and diagnosed as nosocomial infection in our hospital from 2019-2022 were selected as research objects.Information on nosocomial infection rate and infection site in these three departments were collected,and bacteria were isolated and identified ac⁃cording to the methods in the National Clinical Examination Operating Procedures.VITEK-2Compact automatic bacterial identification instrument from France Biomeerieux and DL-96 automatic bacterial determination system from Zhuhai were used for bacterial identifi⁃cation and drug susceptibility tests,and the results were judged according to the standards of CLSI.Results:Among the 227,124 pedi⁃atric,obstetric and gynecological patients included in the study from 2019 to 2022,770 cases of nosocomial infection occurred,with an incidence rate of 0.34%.Among 770 patients with nosocomial infection,bacteremia and gastrointestinal infection were most common in pediatrics,accounting for 31.87%and 26.02%respectively.Other infections of the male and female genital tract and upper respiratory tract infections were more common in obstetrics,accounting for 15.98%and 14.79%respectively.In gynecology,abdominal(pelvic)cavity tissue and acute pelvic inflammation were more common,accounting for 24.32%and 23.94%respectively.A total of 458 strains of pathogens were isolated and cultured from 770 nosocomial infection patients.Staphylococcus epidermidis(S.epidermidis)and Klebsi⁃ella pneumoniae(K.pneumoniae)were the main pathogens in pediatrics,accounting for 23.12%and 20.10%respectively.In obstetrics,Escherichia coli(E.coli)and Enterococcus faecalis(E.faecalis)were dominant,accounting fo

关 键 词：儿科 产科 妇科 院内感染 耐药性 

分 类 号：R197.39[医药卫生—卫生事业管理]