摘要
目的探讨手术室多重耐药菌感染的病原菌分布及相关危险因素,为临床防治手术室多重耐药菌感染提供参考。方法选择2018年1月至2019年2月于本院手术室接受手术治疗的869例患者作为观察对象,对多重耐药菌感染的病原菌分布情况进行分析,经Logistic回归分析探讨感染危险因素。结果78例多重耐药菌感染患者的切口部位共培养、分离病原菌78株,其中22株(28.21%)为革兰氏阳性菌,常见为耐甲氧西林凝固酶阴性葡萄球菌;56株(71.79%)为革兰氏阴性菌,常见为泛耐药铜绿假单胞菌、产超广谱β内酰胺酶大肠埃希菌。患者年龄>60岁、手术室级别等级低、手术无菌用品未达标、手术时间>3小时、手卫生未达标、手术期间人员流动大是手术室多重耐药菌感染的独立危险因素,差异有统计学意义(p<0.05)。结论手术室管理者应根据多重耐药菌分布及相关危险因素给予有效干预,加强院内感染管理,降低院内感染的发生率,保证患者安全。
Objective To explore the distribution of multi-drug resistant organisms(MDRO)and risk factors of MDRO infection in operating room,and to provide reference for preventing MDRO infection in operating room in clinical practice.Methods A total of 869 patients who underwent surgery in our operating room from January 2018 to February 2019 were selected as observation objects.The distribution of MDRO was analyzed,and the risk factors of MDRO infection were explored by Logistic regression analysis.Results MDRO infection appeared in 78 patients,and 78 bacterial strains were cultured and isolated from their incision sites.Among the 78 strains,22(28.21%)were Gram-positive bacteria,mainly methicillin-resistant coagulase-negative staphylococci;56(71.79%)were Gram-negative bacteria,mainly pan-resistant Pseudomonas aeruginosa,and extended-spectrumβ-lactamaseproducing Escherichia coli.Aged>60 years old,low-level operating room,unqualified sterile surgical supplies,operating time>3 hours,poor hand hygiene,and staff turnover during surgery were independent risk factors for MDRO infection in the operating room(p<0.05).Conclusion Operating room managers should provide effective interventions based on MDRO distribution and related risk factors and strengthen the management of nosocomial infections,to reduce the incidence of nosocomial infections and to ensure patient safety.
作者
康星星
王灵娜
黄千瑜
KANG Xing-xing;WANG Ling-na;HUANG Qian-yu(The Second Affiliated Hospital of Wenzhou Medical University)
出处
《医院管理论坛》
2020年第3期38-40,34,共4页
Hospital Management Forum
基金
浙江医药卫生科技项目,编号:2017KY339。
关键词
手术室
院内感染
病原菌分布
多重耐药菌感染
Operating room
Nosocomial infection
Pathogen distribution
multi-drug resistant organisms(MDRO)
