论文部分内容阅读
目的探讨瘫痪患者医院感染的病原菌特点及引起感染的相关危险因素,为瘫痪患者医院感染的防治提供参考依据。方法回顾性分析2012年1月~2013年12月633例瘫痪患者临床资料,采用SPSS13.0和EXCEL8.0软件对病原菌感染特点及相关危险因素进行统计分析。结果共发生医院感染187例次,下呼吸道感染115例次,占61.5%;泌尿道感染54例次,占28.9%;皮肤软组织9例次,占4.8%;其他感染9例次,占4.8%。主要致病菌以革兰阴性菌为主,其中铜绿假单胞菌41株,占21.9%;肺炎克雷伯杆菌36株,占19.3%;大肠埃希菌32株,占17.1%;阴沟肠杆菌9株,占4.8%。革兰阳性菌36株,包括金黄色葡萄球菌25株,占13.4%,凝固酶阴性葡萄球菌11株,占5.9%;念珠菌属9株,占4.8%,其他细菌和真菌16株,占8.6%。年龄≥40岁、住院时间≥30d、手术治疗、侵入性操作、肌力0~Ⅱ级、抗菌药物使用>2种等是发生医院感染的相关因素。结论瘫痪患者医院感染的部位以下呼吸道和泌尿道为主,病原菌主要为革兰阴性菌。高龄、手术、住院时间长、侵入性操作、肌力低、使用多种抗菌药物均是引起瘫痪患者医院感染的相关危险因素。
Objective To investigate the characteristics of nosocomial infections in paralyzed patients and the related risk factors of nosocomial infection, and to provide a reference for the prevention and treatment of nosocomial infections in patients with paralyzed diseases. Methods The clinical data of 633 paralyzed patients from January 2012 to December 2013 were retrospectively analyzed. The characteristics of pathogens and related risk factors were analyzed by SPSS13.0 and EXCEL8.0 software. Results A total of 187 hospital-based nosocomial infections and 115 cases of lower respiratory tract infections were reported, accounting for 61.5%; urinary tract infections were 54 cases, accounting for 28.9%; skin and soft tissues were 9 cases, accounting for 4.8%; other infections were 9 cases, accounting for 4.8% . The main pathogens were gram-negative bacteria, of which 41 strains were Pseudomonas aeruginosa, accounting for 21.9%; 36 strains were Klebsiella pneumoniae, accounting for 19.3%; 32 strains were Escherichia coli, accounting for 17.1% 9 strains of bacteria, accounting for 4.8%. Gram-positive bacteria 36, including Staphylococcus aureus 25, accounting for 13.4%, coagulase-negative Staphylococcus 11, accounting for 5.9%; Candida 9, accounting for 4.8%, other bacteria and fungi 16, accounting for 8.6 %. Age ≥ 40 years of age, hospital stay ≥ 30d, surgical treatment, invasive operation, muscle strength 0 ~ Ⅱ level, the use of antimicrobial agents> 2 are related to the occurrence of nosocomial infections. Conclusions Paralyzed patients with respiratory tract and urinary tract below the site of hospital infection, mainly pathogens Gram-negative bacteria. Elderly, surgery, hospitalization for a long time, invasive procedures, low muscle strength, the use of a variety of antimicrobial agents are paralyzed in patients with nosocomial infection-related risk factors.