某三甲综合医院神经外科2019—2022年医院感染流行病学特征分析  

Analysis of epidemiological characteristics of nosocomial infection in the neurosurgery deparment of a class A tertiary general hospital from 2019 to 2022

作　　者：杨传伟 李娜[1] 孙敏[2] 张欣悦 王昊[3] YANG Chuanwei;LI Na;SUN Min;ZHANG Xinyue;WANG Hao(Department of Pharmacy,Jinan Fourth People's Hospital,Jinan 250031,China;Department of Clinical Pharmacy,Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University,Jinan 250014,China;Department of Intensive Care,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]济南市第四人民医院药学部,济南250031 [2]青岛大学附属山东省妇幼保健院临床药学科,济南250014 [3]山东大学齐鲁医院重症医学科,济南250012

出　　处：《中国药师》2024年第5期772-778,共7页China Pharmacist

基　　金：国家自然科学基金面上项目(82072231);山东省药品临床综合评价项目(2022YZ015);济南市卫生健康委员会科技计划项目(2023-2-79)。

摘　　要：目的调查分析济南市第四人民医院神经外科医院感染流行病学特征,为医院院感防控及抗菌药物合理使用提供参考依据。方法通过医院感染实时监控系统和医院信息系统回顾性收集2019年1月至2022年12月神经外科5200例住院患者感染相关信息,对其感染部位分布、院感发生率、病原菌分布及耐药情况等进行统计和描述性分析。结果2019—2022年,神经外科住院患者平均感染率为3.3%,呈逐年下降的趋势(趋势风险χ^(2)=39.000,P<0.001)。神经外科医院感染多为老年男性患者,感染发生部位以下呼吸道、泌尿系感染、菌血症、颅内感染为主。神经外科2019—2022年共检出病原菌296株,其中革兰氏阴性菌207株(69.9%);革兰氏阳性菌53株(17.9%);真菌36株(12.2%);前4位病原菌分别是肺炎克雷伯菌(21.6%)、铜绿假单胞菌(12.5%)、大肠埃希菌(9.8%)、鲍曼不动杆菌(8.8%)。药敏结果显示,鲍曼不动杆菌对碳青霉烯类抗菌药物耐药情况较为显著。结论该院神经外科这四年来医院感染发生情况逐年好转,检出病原菌以革兰氏阴性菌为主,耐药问题较为突出,应加强耐药管理。Objective To investigate and analyze the epidemiological characteristics of nosocomial infection in the neurosurgery department of Jinan Fourth People's Hospital,and to provide reference for nosocomial infection prevention and control and rational use of antibiotics.Methods The infection related information of 5200 inpatients in neurosurgery from January 2019 to December 2022 was retrospectively collected through the hospital infection monitoring system and hospital information system,and the distribution of infection sites,the incidence of hospital infection,distribution of pathogens and drug resistance were statistically and descriptively analyzed.Results From 2019 to 2022,the average infection rate of inpatients in the neurosurgery department was 3.3%,which was decreased year by year (χ^(2)=39.000,P<0.001).Nococomial infections mostly occurred in elderly male patients,the infection sites were mainly lower respiratory tract,urinary system,bacteremia,and intracranial infection.From 2019 to2022,296 strains of pathogenic bacterium were detected in neurosurgery,including 207 strains of Gram-negative bacteria,accounting for 69.9%;53 Gram-positive bacterium,accounting for 17.9%;36 Fungi,accounting for 12.2%.The top four pathogens were Klebsiella pneumoniae(21.6%),Pseudomonas aeruginosa (12.5%),Escherichia coli (9.8%),and Acinetobacter baumannii (8.8%).The drug sensitivity results showed that the resistance of Acinetobacter baumannii to carbapenems was significant.Conclusion In the past four years,the incidence of nosocomial infections of the Neurosurgery department has improved year by year.The pathogenic bacteria detected were mainly gram-negative bacteria,and the problem of drug resistance is more prominent.The drug resistance management should be strengthened.

关 键 词：神经外科 医院感染 耐碳青霉烯鲍曼不动杆菌 流行病学 耐药性 抗菌药物 

分 类 号：R197.323[医药卫生—卫生事业管理]