摘要
目的探讨和分析衢州市急诊科病房感染患者病原学分析及危险因素。方法选取2016年5月~2017年5月衢州市医院收治的急诊科病房感染患者268例,回顾性分析参与本研究的急诊科病房感染患者的临床资料,并对其感染的病原学特点进行研究分析。结果268例急诊科病房感染患者,院内感染29例,其中呼吸道感染15例,泌尿道感染5例,血液感染与胸腔感染各3例,腹腔感染2例,手术切口感染1例。采用单因素、多因素Logistic回归分析发现使用≥60岁患者的感染率显著高于<60岁的患者(P<0.05),呼吸机是主要导致感染发生的危险因素;共有201株病原菌被分离出来,其中最常见的是支原体、真菌、革兰阴性菌及革兰阳性球菌,同时革兰阴性杆菌与其他病原菌相比所占比例最高(P<0.05);以大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、鲍曼不动杆菌、铜绿假单胞菌的排名在前五位。其中革兰阴性菌耐药性较高的为:丁胺卡那、左氧氟沙星、头孢曲松、环丙沙星、亚胺培南、氨曲南。结论革兰阴性菌是导致急诊科重症患者医院感染的主要病原菌,为了对临床抗感染效果有一定的保证,在选择抗菌药时要与患者临床药敏试验结果进行合理的结合。
Objective To investigate the pathogenic analysis and risk factors of patients with ward infection in emergency department of Quzhou City.Methods A total of 268 patients with ward infection in emergency department admitted in the hospital from May 2016 to May 2017 were selected.The clinical data of patients with ward infection in the emergency department who participated in the study were retrospectively analyzed,and the pathogenic characteristics of the infection were investigated and analyzed.Results In 268 patients with ward infection in emergency department,there were 29 patients with nosocomial infections,including 15 cases of respiratory infections,5 cases of urinary tract infections,3 cases of blood infections and chest infections,2 cases of abdominal infections and one case of surgical wound infection.Univariate and multivariate logistic regression analysis showed that the infection rate of patients aged≥60 years was significantly higher than that of patients<60 years old(P<0.05).The ventilator was the main risk factor for infection.A total of 201 pathogens were isolated.Among them,the most common ones were mycoplasma,fungi,Gram-negative bacteria and Gram-positive cocci,while Gram-negative bacteria had the highest proportion compared with other pathogens(P<0.05).Escherichia coli and pneumonia Klebsiella pneumoniae,Staphylococcus aureus,Acinetobacter baumannii,and Pseudomonas aeruginosa were ranked in the top five.And the drugs with high resistance were amikacin,levofloxacin,ceftriaxone,ciprofloxacin,imipenem,and aztreonam.Conclusion Gram-negative bacteria are the main pathogens causing nosocomial infection in critically ill patients in emergency department.In order to ensure the clinical anti-infective effect,it is necessary to make a reasonable combination with the clinical drug sensitivity test results when selecting antibacterial drugs.
作者
徐小良
吴德军
崔益明
陈毓
XU Xiaoliang;WU Dejun;CUI Yiming;CHEN Yu(Department of Emergency,Quzhou People's Hospital in Zhejiang Province,Quzhou 324000,China)
出处
《中国现代医生》
2020年第5期91-94,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2017KY699)。
关键词
急诊科
病房感染
病原学分析
抗菌药物
革兰阴性菌
Department of emergency
Ward infection
Pathogenic analysis
Antibacterial drugs
Gram-negative bacteria
