摘要
目的观察鼾症患者手术后医院感染的临床特点,分析病原学及药敏特征,为临床治疗提供参考依据。方法回顾性研究鼾症术后发生医院感染的74例患者临床资料,并进行细菌培养及药敏鉴定,同时观察药敏情况及预后的影响。结果 74例患者医院感染中,肺部感染最多69例占93.24%,手术切口4例占5.41%,消化系统1例占1.35%;共检出病原菌99株,革兰阴性杆菌61株占61.62%,革兰阳性菌35株占35.35%,真菌3株占3.03%;感染的发生率与吸烟史、肾上腺皮质激素应用时间、预防性应用抗菌药物有关,金黄色葡萄球菌和屎肠球菌对万古霉素高度敏感,敏感率达100.00%;铜绿假单胞菌和肺炎克雷伯菌对亚胺培南高度敏感,敏感率为100.00%。结论鼾症围术期要严格无菌操作,并做好预防医院感染的管理工作,对感染的患者及时进行分泌物细菌培养及耐药性的检测,以指导临床医师合理选用抗菌药物治疗。
OBJECTIVE To observe the clinical characteristics of nosocomial infections in the patients after the snoring surgery and analyze the etiological and drug susceptibility characteristics so as to guide the clinical treatment. METHODS The clinical data of 74 patients who were with nosocomial infections after the snoring surgery were retrospectively reviewed, the bacterial culture and the drug susceptibility testing were performed, and the drug susceptibility testing results and the prognosis were observed at the same time. RESULTS Of 74 patients with nosocomial infections, there were 69 （93. 24%） patients with pulmonary infections, 4 （5. 41%） patients with surgical incision infections, and 1 （1.35%） patient with gastrointestinal tract infections. A total of 99 strains of pathogens were isolated, including 61 （61. 62%） strains of gram-negative bacilli, 35 （35. 35%） strains of gram-positive bacteria, and 3 （3.03%） strains of fungi. The incidence rate of infections was correlated with the smoking history, adrenal cortical hormone, and antibiotic prophylaxis. Staphylococcus aureus and En-terococcus faecium strains were highly sensitive to vancomycin, and Pseudomonas aeruginosa and Klebsiella pneu-monia strains were highly sensitive to imipenem. CONCLUSION The aseptic operation is important to snoring sur-gery. We should strengthen the management of hospital infections. For the patients with infections, it is necessary to perform the bacterial culture of secretions and the detection of drug resistance in a timely manner so as to guide the reasonable use of antibiotics.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第11期2627-2629,共3页
Chinese Journal of Nosocomiology
关键词
鼾症手术
医院感染
细菌培养
病原菌
药敏
Snoring surgery
Nosocomial infection
Bacterial culture
Pathogen
Drug susceptibility
