CAJ | 학술논문

目的：探讨消化内镜室患者医院感染的病原菌分布及感染预防措施，以降低消化内镜医院感染率。方法选取2012年1月－2014年6月医院收治的834例行消化内镜检查患者，对患者的临床资料进行回顾性分析，研究患者医院感染类型、感染病原菌及预防措施；采用SPSS17．0软件进行统计分析。结果834例患者中98例发生医院感染，感染率为11．75％；感染部位以消化系统、上呼吸道、下呼吸道及泌尿道感染为主，分别占40．82％、18．37％、17．35％及11．22％；共分离病原菌98株，其中革兰阴性菌49株占50．00％，以铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌为主，革兰阳性菌43株占43．88％，以金黄色葡萄球菌、表皮葡萄球菌为主，真菌6株占6．12％，以白色假丝酵母菌为主，实施干预措施后，胃镜和肠镜内镜、水槽、消毒液、医护人员手卫生合格率显著高于实施前，差异有统计学意义（P＜0．01）。结论对消化内镜医院感染患者进行病原菌检测及感染预防措施研究，可有效降低消化内镜医院感染率。
목적：탐토소화내경실환자의원감염적병원균분포급감염예방조시，이강저소화내경의원감염솔。방법선취2012년1월－2014년6월의원수치적834례행소화내경검사환자，대환자적림상자료진행회고성분석，연구환자의원감염류형、감염병원균급예방조시；채용SPSS17．0연건진행통계분석。결과834례환자중98례발생의원감염，감염솔위11．75％；감염부위이소화계통、상호흡도、하호흡도급비뇨도감염위주，분별점40．82％、18．37％、17．35％급11．22％；공분리병원균98주，기중혁란음성균49주점50．00％，이동록가단포균、폐염극뢰백균、포씨불동간균위주，혁란양성균43주점43．88％，이금황색포도구균、표피포도구균위주，진균6주점6．12％，이백색가사효모균위주，실시간예조시후，위경화장경내경、수조、소독액、의호인원수위생합격솔현저고우실시전，차이유통계학의의（P＜0．01）。결론대소화내경의원감염환자진행병원균검측급감염예방조시연구，가유효강저소화내경의원감염솔。
OBJECTIVE To explore the distribution of pathogens causing nosocomial infections in the patients un‐dergoing gastrointestinal endoscopy and put forward the prevention measures so as to reduce the incidence of the nosocomial infections .METHODS A total of 834 patients who underwent the gastrointestinal endoscopy from Jan 2012 to Jun 2014 were enrolled in the study ,then the clinical data of the patients were retrospectively analyzed , the types of the nosocomial infections and the distribution of the pathogens were observed ,the prevention meas‐ures were put forward ,and the statistical analysis was performed with the use of SPSS17 .0 software .RESULTS The nosocomial infections occurred in 98 of 834 patients with the infection rate of 11 .75% ,of whom 40 .82% had the digestive system infections ,18 .37% had the upper respiratory tract infections ,17 .35% had the lower respira‐tory tract infections ,and 11 .22% had the urinary tract infections .Totally 98 strains of pathogens have been isola‐ted ,including 49 (50 .00% ) strains of gram‐negative bacteria ,43 (43 .88% ) strains of gram‐positive bacteria ,and 6 (6 .12% ) strains of fungi;the Pseudomonas aeruginosa ,Klebsiella pneumoniae ,and Acinetobacter baumannii were dominant among the gram‐negative bacteria;the Staphylococcus aureus and Staphylococcus epidermidis were the predominant species of gram‐positive bacteria;the Candida albicans was the major species of fungi .The qualified rates of the gastroscopes ,enteroscopes ,sinks ,disinfectants ,and hand hygiene of health care workers were significantly higher after the interventions were taken than before they were taken(P<0 .01) .CONCLUSION It is an effective way to carry out the detection of the pathogens causing the nosocomial infections in the patients undergoing the gastrointestinal endoscopy and take the targeted prevention measures so as to reduce the incidence of the nosocomial infections .