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目的利用医院感染实时监控系统(RT-NNIS)分析医院肝胆外科医院感染情况,明确重点感染部位、主要病原菌及相关危险因素,为临床预防控制医院感染提供依据。方法收集2012年1月1日-2015年12月31日肝胆外科16 820例患者资料,对其感染率、感染部位及致病菌应用构成比进行统计描述,利用单因素分析研究医院感染的相关因素。结果观察期间,肝胆外科5个病区总住院患者为16 820例,其中感染819例,总感染率为4.87%,感染部位前3位依次为手术部位感染、菌血症、下呼吸道感染,主要致病菌前3位依次为肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌;单因素分析结果显示,男性、年龄≥65,手术、入住ICU、使用抗菌药物及使用中心静脉插管、尿管、呼吸机是肝胆外科发生医院感染的危险因素(P<0.05)。结论肝胆外科医院感染发病率较高,菌种和感染部位较为集中,临床工作中应对重点感染部位和重点菌种高度重视。
Objective To analyze the hospital infection of hepatobiliary surgery by RT-NNIS, to clarify the key infection sites, major pathogens and related risk factors, so as to provide evidence for clinical prevention and control of nosocomial infections. Methods The data of 16 820 patients from January 1, 2012 to December 31, 2015 in hepatobiliary surgery were collected. The infection rate, the location of infection and the constituent ratio of pathogens were statistically analyzed. The correlations of nosocomial infections were analyzed by univariate analysis factor. Results During the observation period, there were 16 820 hospitalizations in 5 wards of hepatobiliary surgery, of which 819 were infected with a total infection rate of 4.87%. The top three sites of infection were as follows: surgical site infection, bacteremia, lower respiratory tract infection, The first three pathogenic bacteria were Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli. The results of univariate analysis showed that male, age≥65, surgery, admitted to the ICU, antibacterial drugs and central venous catheterization Tubes, catheters and ventilator were the risk factors of nosocomial infection in hepatobiliary surgery (P <0.05). Conclusion The prevalence of nosocomial infection in hepatobiliary surgery is high, and the bacterial strains and the infected parts are more concentrated. In the clinical work, emphasis should be placed on the key infected parts and key species.