CAJ | 학술논문

目的分析重症肝炎患者人工肝术后并发感染的病原菌分布及耐药情况.方法回顾性调查88例重症肝炎患者人工肝术后并发感染的临床资料,对感染病原菌的分布及耐药率进行统计分析.结果重症肝炎患者人工肝术后感染发生率为30.34%.88例患者感染的主要部位为:肺部(27.03%)、口腔(22.30%)、肠道(19.59%)、胆道(15.54%).2种以上细菌混合感染患者占54.67%.在分离的病原菌株中,真菌比例最高,占55.24%,其中白色念珠菌占19.58%,热带念珠菌占14.69%,革兰氏阳性菌占23.78%,肠球菌占9.09%,葡萄球菌5.59%,链球菌4.20%;革兰氏阴性菌占20.98%,肺炎克雷伯氏菌占8.39%,大肠埃希氏菌占4.90%.真菌对二性霉素B最敏感,其次为氟康唑;革兰氏阳性菌对万古霉素、替考拉宁最敏感;革兰氏阴性菌对亚胺培南、阿米卡星敏感.结论重症肝炎患者人工肝术后感染发生率高,多部位及细菌混合感染多见.所分离的病原菌中,真菌比例最高,病原菌对临床上常用抗生索有较高的耐药性.为降低人工肝术后感染的发生率,应尽量减少和避免诱发感染的危险因素,采取综合防治措施.
목적 분석중증간염환자인공간술후병발감염적병원균분포급내약정황.방법 회고성조사88례중증간염환자인공간술후병발감염적림상자료,대감염병원균적분포급내약솔진행통계분석.결과 중증간염환자인공간술후감염발생솔위30.34%.88례환자감염적주요부위위:폐부(27.03%)、구강(22.30%)、장도(19.59%)、담도(15.54%).2충이상세균혼합감염환자점54.67%.재분리적병원균주중,진균비례최고,점55.24%,기중백색념주균점19.58%,열대념주균점14.69%,혁란씨양성균점23.78%,장구균점9.09%,포도구균5.59%,련구균4.20%;혁란씨음성균점20.98%,폐염극뢰백씨균점8.39%,대장애희씨균점4.90%.진균대이성매소B최민감,기차위불강서;혁란씨양성균대만고매소、체고랍저최민감;혁란씨음성균대아알배남、아미잡성민감.결론 중증간염환자인공간술후감염발생솔고,다부위급세균혼합감염다견.소분리적병원균중,진균비례최고,병원균대림상상상용항생색유교고적내약성.위강저인공간술후감염적발생솔,응진량감소화피면유발감염적위험인소,채취종합방치조시.
Objective To investigate the distribution of pathogen and drug resistance in the patients with serious hepatitis complicating nosocomial infection after artificial liver system treatment.Methods The clinical data of 88 cases of severe hepatitis complicating nosocomial infection after artificial liver system treatment were investigated and analyzed retrospectively.Results Infection occurred in 30.34% patients after artificial liver system treatment,the major infectious parts of 88 cases were lung(27.03%),oral cavity(22.30%),intestines tract(19.59%)、biliary tract(15.54%).Mixed infections of over two strains of bacteria were 54.67%.Fungus occupied 55.24% in the separated bacterial strains(Canda albicans 19.58%,Albicans tropicals 14.69%);Grampositive bacteria occupied 23.78%(Enterococci 9.09%,Staphylococci 5.59%,Streptococci 4.20%);Gram-negative bacteria occupied 20.98%(Klebsiella pneutmoniae 8.39%,Escherichia coli 4.90%).Funguses were most sensitive to Amphomoronal B,Fluconazole secondly.Gram-positive bacteria were sensitive to Vancomycin and Teicoplanin,Gram-negative bacteria were sensitive to Imipenem and Amikacin.Conclusion The incidence rate of infection is high in the patients with severe hepatitis after artifical liver system treatment.Fungus occupy the major part of the separated pathogen,most pathogens are resisted to common antibacterial agent.Comprehensive measures must be taken to prevent and avoid the risk of infection.