神经外科监护病房医院感染流行病学分析及耐药性调查

目的:探讨神经外科监护病房(NICU)医院感染病原学分布特征及其耐药性特点,为临床治疗提供指导。方法:对某院NICU的179例医院感染患者进行临床资料分析。结果:179例患者共培养出菌株346株,病原菌以革兰阴性杆菌为主(52.89%),革兰阳性球菌为38.15%,真菌为8.96%。以下呼吸道感染居多(83.80%),其次为泌尿道感染(10.61%)、血管相关性感染(2.79%)、中枢神经系统感染(1.68%)和血液系统感染(1.12%)。结论:降低NICU内医院感染率的重点是控制下呼吸道感染,急性期加强革兰阳性球菌感染的预防和治疗,后期加强对革兰阴性杆菌感染的预防和治疗,在标准预防的基础上采取额外预防措施,有效控制耐药菌株的发生。

An analysis of the characteristics of etiology and drug resistance of nosocomial infection in the neurosurgery intensive care unit

Objective: To investigate the characteristics of etiology and drug resistance of nosocomial infection in the neurosurgery intensive care unit(NICU),and provide useful information for clinical practice.Methods: We analyzed the clinical data of 179 cases of nosocomial infection among 1 163 patients admitted in the NICU from June 2005 to March 2007.Results: From the 179 patients,346 strains of bacteria were obtained,of which Gram's negative bacili accounted for 52.89%,Gram's positive cocci 38.15% and fungi 8.96%.Of the diagnosed nosocomial infections,83.80% involved the lower respiratory tract,10.61% the urinary tract,2.79% the blood vessels,1.68% the central nervous system and 1.12% the hematological system.Conclusion: To reduce nosocomial infections in the NICU,emphasis should be placed on the control of lower respiratory tract infection as well as on the prevention and treatment of Gram's positive coccus infection in the acute stage and Gram's negative bacillus infection in the later stage.Intensified prevention measures based on the standard ones could help to get the drug-resistant strains under control.