摘要
目的了解基层医院急诊科重症患者并发医院感染的危险因素及病原菌状况,为临床医师诊断与治疗提供参考依据。方法调查分析2010年1月-2012年12月急诊科1 207例危重患者的临床资料,医院感染病原菌培养和鉴定按照《全国临床检验操作规程》,采用临床病原菌检验常规方法进行;药敏试验采用WHO规定的K-B法进行操作,药敏结果敏感、中介、耐药的评价依据CLSI的最新标准。结果 1 207例急诊科重症患者中发生医院感染178例、211例次,感染率14.7%、例次感染率17.5%;感染部位以下呼吸道感染为主,占62.1%;基础疾病、有创性诊疗操作、广谱抗菌药物的过量使用等为患者医院感染危险因素;检出耐甲氧西林葡萄球菌21株,检出率为44.7%,检出产超广谱β-内酰胺酶细菌30株,检出率为41.7%。结论必须增强急诊科医师预防医院感染与合理用药理念,切实执行卫生部《抗菌药物临床应用管理办法》,降低急诊科医院感染率。
OBJECTIVE To understand risk factors and bacteria causing nosocomial infection in critical patients in the emergency department in grass-root hospital, so as to provide the referrence for clinical diagnosis and treatment. METHODS The clinical records of critical patients from Jan. 2010 to Oct. 2012 in our emergency department were reviewed. Bacterial cultwre and identification were carried out by the routine methods according to National Guide to Clinical Laboratory Procedures. The susceptibility testing was performed by K-B method recommended by WHO. The susceptibility testing results were assessed by breakpoints of CLSI. RESULTS Among 1 207 critical patients in the emergency department, 178 cases 211 cases time oulred nosocomial infection and, The occurrance of nosocomial infection was 14.7%, and the case infection rate was 17.5%. The lower respiratory tract infection occurred most frequently （62.1%）. The potential risk factors were underlying disease, invasive operation, abuse of broad-spectrum antibiotics, etc. A total of 21 （MRSA） Methicilsin-resistant staphylococeus were isolated, accounting for 44. 7 %. 30 of ESBLs-producing bacteria were isolated, accounting for 41. 7 %. CONCLUSION Prevention from nosocomial infection and resonable use of antibiotics should be strengthened for the clinicians in the emergency department. Management of application of antibiotics should be implemented practically to reduce the occurrence of nosocomial infection in the emergency department.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第5期1141-1143,共3页
Chinese Journal of Nosocomiology
基金
荆州市科技局基金项目(2010ZD-17)
关键词
急诊科
重症患者
医院感染
危险因素
病原菌
Emergency department
Critical patients
Nosocomial infection
Risk factor
Pathogenic bacteria
