中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2010年
12期
1304-1306
,共3页
杨立明%陈洁%陈松涛%刘桢干
楊立明%陳潔%陳鬆濤%劉楨榦
양립명%진길%진송도%류정간
监护病房%医院感染%病原菌%耐药性
鑑護病房%醫院感染%病原菌%耐藥性
감호병방%의원감염%병원균%내약성
Intensive care unit%Hospital infection%Pathogens%Drug-resistance
目的 了解新建综合监护病房(ICU)医院感染特点及病原学耐药情况,为临床合理用药提供依据.方法 采用回顾性调查方法,分析我院综合ICU成立1年来收治且纳入研究的142例患者的医院感染情况并与同期我院收治的其他住院患者相比较.结果 142例中共22例31例次发生医院感染,ICU医院感染率为15.49%,例次感染率21.83%;同期我院共收治住院患者15 978例,其中324例413例次发生医院感染,医院感染率为2.03%,按例次计为2.58%.ICU与全院医院感染率相比,差异有统计学意义(P均＜0.01).ICU感染好发部位主要为下呼吸道感染,占70.96%;病原菌以革兰阴性杆菌为主(65.12%),其次为革兰阳性球菌(23.26%)及真菌(11.63%);最常见病原菌为大肠埃希菌(32.56%)及金黄色葡萄球菌(11.63%);革兰阴性菌对头孢哌酮/舒巴坦、亚胺培南、美洛培南、哌拉西林/他唑巴坦均高度敏感;革兰阳性菌对万古霉素、利奈唑胺、替考拉宁100%敏感.结论 新建ICU医院感染病原菌在构成、分布及耐药性等方面与国内研究结果基本一致;革兰阴性菌为其主要病原菌,大肠埃希菌占医院感染的第一位.
目的 瞭解新建綜閤鑑護病房(ICU)醫院感染特點及病原學耐藥情況,為臨床閤理用藥提供依據.方法 採用迴顧性調查方法,分析我院綜閤ICU成立1年來收治且納入研究的142例患者的醫院感染情況併與同期我院收治的其他住院患者相比較.結果 142例中共22例31例次髮生醫院感染,ICU醫院感染率為15.49%,例次感染率21.83%;同期我院共收治住院患者15 978例,其中324例413例次髮生醫院感染,醫院感染率為2.03%,按例次計為2.58%.ICU與全院醫院感染率相比,差異有統計學意義(P均＜0.01).ICU感染好髮部位主要為下呼吸道感染,佔70.96%;病原菌以革蘭陰性桿菌為主(65.12%),其次為革蘭暘性毬菌(23.26%)及真菌(11.63%);最常見病原菌為大腸埃希菌(32.56%)及金黃色葡萄毬菌(11.63%);革蘭陰性菌對頭孢哌酮/舒巴坦、亞胺培南、美洛培南、哌拉西林/他唑巴坦均高度敏感;革蘭暘性菌對萬古黴素、利奈唑胺、替攷拉寧100%敏感.結論 新建ICU醫院感染病原菌在構成、分佈及耐藥性等方麵與國內研究結果基本一緻;革蘭陰性菌為其主要病原菌,大腸埃希菌佔醫院感染的第一位.
목적 료해신건종합감호병방(ICU)의원감염특점급병원학내약정황,위림상합리용약제공의거.방법 채용회고성조사방법,분석아원종합ICU성립1년래수치차납입연구적142례환자적의원감염정황병여동기아원수치적기타주원환자상비교.결과 142례중공22례31례차발생의원감염,ICU의원감염솔위15.49%,례차감염솔21.83%;동기아원공수치주원환자15 978례,기중324례413례차발생의원감염,의원감염솔위2.03%,안례차계위2.58%.ICU여전원의원감염솔상비,차이유통계학의의(P균＜0.01).ICU감염호발부위주요위하호흡도감염,점70.96%;병원균이혁란음성간균위주(65.12%),기차위혁란양성구균(23.26%)급진균(11.63%);최상견병원균위대장애희균(32.56%)급금황색포도구균(11.63%);혁란음성균대두포고동/서파탄、아알배남、미락배남、고랍서림/타서파탄균고도민감;혁란양성균대만고매소、리내서알、체고랍저100%민감.결론 신건ICU의원감염병원균재구성、분포급내약성등방면여국내연구결과기본일치;혁란음성균위기주요병원균,대장애희균점의원감염적제일위.
Objective To study characteristics of hospital infection and bacterial drug-resistance in our new Intensive Care Unit (ICU) to provide evidence to clinical rational use of drugs. Methods The data of 142 patients in our ICU last year were analyzed retrospectively, and compared to other inpatients treated in general ward during the same time period. Results Among the 142 ICU inpatients,31 times of hospital infection occurred in 22 patients,gave rise to a infection rate of 15.49% and case time infection rate of 21.83% in ICU; but among the 15 978patients treated simultaneously in general ward,413 times of hospital infection occurred in 324 inpatients, gave rise to a infection rate of 2. 03% and case time infection rate of 2. 58% outside of ICU. The hospital infection rate and case time infection rate were significantly different between the ICU and general ward (P ＜ 0. 01 ). Among the ICU infections, the lower respiratory tract infection accounted for 70. 96% ;the main pathogens were Gram-negative bacilli (65. 12% ) and Gram-positive bacilli (23.26%), follwed by fungus (11.63%). The most common bacteria were Escherichia ( 32. 65% ) and Staphylococcus ( 11.63% ). Gram-negative microorganisms were highly sensitive to cefoperazone/sulbactam,imipenem, meropenem and piperacillin/tazobactam; all Gram-positive microorganisms were sensitive to vancomycin,linezolid and teicoplanin. Conclusions The constitution,distribution and drug-resistance of pathogens in new ICU are similar to previous domestic reports. Gram-negative organisms are the main photogenic bacteria of hospital infection in ICU, and Escherichia is the most popular type in nosocomial infection.
