CAJ | 학술논문

目的：探讨心内科住院患者发生医院感染部位及感染病原菌种类与耐药性，为临床防治感染提供参考。方法回顾性分析2010年3月－2013年12月心内科1396例住院患者的临床资料；对患者医院感染率、感染部位分布、病原菌种类与耐药性进行统计分析，采用SPSS17．0软件进行统计分析。结果1396例住院患者中有42例发生医院感染，感染率为3．01％；感染部位以下呼吸道、泌尿道和消化道感染为主，分别占40．48％、21．42％和14．29％；共分离出病原菌61株，其中革兰阴性菌39株占63．93％，以大肠埃希菌、铜绿假单胞菌为主，革兰阳性菌18株占29．51％，以金黄色葡萄球菌为主，真菌4株占6．56％，以光滑假丝酵母菌为主；大肠埃希菌对庆大霉素和红霉素耐药率＞53．00％，对阿米卡星、亚胺培南和美罗培南耐药率＜7．00％；铜绿假单胞菌对头孢哌酮、庆大霉素和红霉素耐药率＞54．00％，对阿米卡星、亚胺培南和美罗培南耐药率＜10．00％；金黄色葡萄球菌对头孢克肟、头孢哌酮和环丙沙星耐药率＞55．00％，对庆大霉素、红霉素、氧氟沙星和阿米卡星耐药率＜34．00％。结论心内科住院患者医院感染率处于较高水平，感染部位多见于下呼吸道，感染病原菌以革兰阴性菌为主，临床上应加强病原菌监测，并制定相应措施，从而有效减少医院感染。
목적：탐토심내과주원환자발생의원감염부위급감염병원균충류여내약성，위림상방치감염제공삼고。방법회고성분석2010년3월－2013년12월심내과1396례주원환자적림상자료；대환자의원감염솔、감염부위분포、병원균충류여내약성진행통계분석，채용SPSS17．0연건진행통계분석。결과1396례주원환자중유42례발생의원감염，감염솔위3．01％；감염부위이하호흡도、비뇨도화소화도감염위주，분별점40．48％、21．42％화14．29％；공분리출병원균61주，기중혁란음성균39주점63．93％，이대장애희균、동록가단포균위주，혁란양성균18주점29．51％，이금황색포도구균위주，진균4주점6．56％，이광활가사효모균위주；대장애희균대경대매소화홍매소내약솔＞53．00％，대아미잡성、아알배남화미라배남내약솔＜7．00％；동록가단포균대두포고동、경대매소화홍매소내약솔＞54．00％，대아미잡성、아알배남화미라배남내약솔＜10．00％；금황색포도구균대두포극우、두포고동화배병사성내약솔＞55．00％，대경대매소、홍매소、양불사성화아미잡성내약솔＜34．00％。결론심내과주원환자의원감염솔처우교고수평，감염부위다견우하호흡도，감염병원균이혁란음성균위주，림상상응가강병원균감측，병제정상응조시，종이유효감소의원감염。
OBJECTIVE To investigate the distribution and drug resistance of the pathogens causing nosocomial in‐fections in the hospitalized patients of cardiology department and observe the nosocomial infection sites so as to provide guidance for clinical prevention and treatment .METHODS The clinical data of 1 396 patients who were hospitalized the cardiology department from Mar 2010 to Dec 2013 were retrospectively analyzed ,then the inci‐dence of nosocomial infections ,distribution of infection sites ,distribution of pathogens ,and drug resistance were statistically analyzed ,and the statistical analysis was performed with the use of SPSS17 .0 software .RESULTS The nosocomial infections occurred in 42 of 1 396 hospitalized patients with the infection rate of 3 .01% ,of whom 40 .48% had the lower respiratory tract infections ,21 .42% had the urinary tract infections ,and 14 .29% had the gastrointestinal tract infections .Totally 61 strains of pathogens have been isolated ,including 39 (63 .93% ) strains of gram‐negative bacteria ,18 (29 .51% ) strains of gram‐positive bacteria ,and 4 (6 .56% ) strains of fungi;the Escherichia coli and Pseudomonas aeruginosa were the predominant gram‐negative bacteria;the Staphylococcus aureus was dominant among the gram‐positive bacteria;the Candida glabrata was the predominant species of fun‐gus .The drug resistance rates of the E .coli to gentamicin and erythromycin were more than 53 .00% ,while the drug resistance rates to amikacin ,imipenem ,and meropenem were less than 7 .00% ;the drug resistance rates of the P .aeruginosa to cefoperazone ,gentamicin ,and erythromycin were more than 54 .00% ,and the drug resist‐ance rates to amikacin ,imipenem ,and meropenem were less than 10 .00% ;the drug resistance rates of the S .au‐reus to cefixime ,cefoperazone ,and ciprofloxacin were more than 55 .00% ,while the drug resistance rates to gen‐tamicin ,erythromycin ,ofloxacin ,and amikacin were less than 34 .00% .CONCLUSION The incidence of nosoco‐mial infections is high in the hospitalized patients of cardiology department ;the lower respiratory tract is the com‐mon infection site ,and the gram‐negative bacteria are dominant among the pathogens causing infections .It is nec‐essary for the hospital to strengthen the surveillance of the pathogens and formulate corresponding measures so as to effectively reduce the incidence of the nosocomial infections .