消化道外科手术部位感染的病原学特点和防治对策

美国疾病控制中心(Centers for Disease Control, CDC)将外科手术部位感染(surgical site infection,SSI)分为切口和器官/无菌体腔感染[1].     

泌尿系感染的病原学及耐药性分析

随着抗生素的广泛应用 ,病原菌的耐药性日益严重 ,临床上难治性的泌尿系统感染也日趋增多。我们收集了本院近 2年半来尿培养中分离的 5 32株细菌 ,对其致病菌谱及耐药性进行分析 ,为临床医生合理选择抗生素提供依据。1　资料与方法1 .1　资料　菌株来源于 1 998年 9月 - 2 0 0 0年 1 2月同济医院门诊和住院患者的尿培养标本 ,共分离出致病菌 5 32株 ,经常规方法鉴定。1 .2　方法　 1药敏试验 :按照美国临床实验室标准委员会 ( NCCLS) 1 993年 1 2月版制的纸片扩散法法规进行[1] 。所用 2 0种药敏纸片除头孢吡肟、头孢西丁、泰能纸片为英国…     

院内下呼吸道感染病原学及耐药性研究

院内下呼吸道感染是最常见的医院内感染之一,其发生率和病死率很高,已引起医学界的极大关注.本文通过对70例院内下呼吸道感染患者进行病原学及细菌耐药分析,旨在更准确地指导抗生素的应用.1 实验过程和方法1.1 研究对象 参照1990年院内获得性支气管-肺感染试行标准及原有慢性肺疾病的院内下呼吸道感染的诊断标准.从1994～1996年两年间选出符合条件的70例无纤维支气管镜(纤支镜)禁忌的院内下呼吸道感染患者作为研究对象.其中男41例,女29例.年龄22～78岁,平均年龄56岁.所有患者均有一种以上基础疾病,其中慢性肺疾病45例,恶性肿瘤12例,结缔组织病及应用类固醇激素者7例,机械通气者4例,糖尿病2例.70例患者平均体温为38.4℃(范围在36.8～39.5℃),平均WBC为15.O×10~9/L(范围6.1～47)×10~9/L).66例患者在进行纤支镜检查前均用过一种以上抗生素治疗.     

恶性肿瘤放化疗住院患者医院感染的病原学及预防

目的：总结恶性肿瘤放化疗住院患者发生医院感染（院感）的病原学,为临床防控院感提供参考。方法：回顾性分析2015年1月至2021年12月江苏省肿瘤医院放疗科9694例恶性肿瘤住院患者住院期间采集的痰、咽拭子、分泌物、尿、导管末端、外周血及导管血培养标本检测结果,由感控科跟踪细菌培养阳性标本患者,排除院外感染、细菌定植、免疫性炎症及标本污染,得到医院感染率和医院感染例次率,分析感染部位与易感因素。结果：9694例住院患者共送检痰、咽试子、分泌物、尿、导管、外周血、导管血培养标本1976份,致病菌阳性标本数253,阳性标本检出率12.8%,医院感染率0.99%,医院感染例次率1.01%。病原学分布以白假丝酵母菌最多,其次为金黄色葡萄球菌、产酸克雷伯菌、肺炎克雷伯菌、铜绿假单胞菌、人葡萄球菌、近平滑假丝酵母菌、大肠杆菌、阴沟肠杆菌。易感因素有病期晚、住院时间长、营养不良、骨髓抑制、侵入性操作、抗生素的不合理使用与放射性皮肤黏膜炎。结论：恶性肿瘤放化疗患者多种因素导致院感,需通过正确有效的预防减少其发生。     

外科手术部位感染的前瞻性监测与预防

手术部位感染是术后患者常见的医院内感染和手术并发症，居医院感染的第3位，占住院患者医院感染的14％～16％。手术部位感染不但延长了患者住院的时间，而且提高了发病率和死亡率，给患者的身体和经济带来了沉重的负担。本研究通过对外科手术患者进行前瞻性调查研究，分析手术部位感染的危险因素，以便采取有效措施，预防和控制手术部位感染的发生，现报道如下。     

肺结核继发性肺部感染的病原学分析

从 2 0 0 0年 10月至 2 0 0 1年 8月 ,我院共对 2 819份结核病人的痰标本进行了细菌及真菌培养和鉴定 ,现将结果报告如下。1　材料与方法1 1　标本来源　所有痰标本均来自我院住院和门诊病人。标准质控菌株 ;金黄色葡萄球菌ＡＴＣＣ 2 5 92 3、大肠埃希菌ＡＴＣＣ 2 5 92 2、铜绿假单胞菌ＡＴＣＣ 2 785 3购自中国药品生物制品检定所。1 2　主要仪器和试剂　ＡＰＩ微生物鉴定系统 ,微生物生化鉴定板条 ,哥伦比亚血琼脂基础及麦康凯琼脂均为梅里埃生物公司产品。念珠菌显色培养基 ;Ｃｈｒｏｍａｇａｒ公司 ;沙保罗琼脂及药敏纸片为天和微生物…     

支气管扩张合并感染的病原学及药敏分析

目的分析2006年度广州呼吸疾病研究所支气管扩张合并感染住院患者的病原学及药敏情况。方法对2006年度广州呼吸疾病研究所因支气管扩张合并感染需要住院病例170例的痰培养和药敏进行回顾分析。结果170例痰培养66例阳性,阳性率为38.8%,最常见的病原菌为铜绿假单孢菌。结论革兰阴性杆菌特别是铜绿假单孢杆菌感染是引起支气管扩张感染加重住院的主要因素。在抗菌药物应用时宜选用对假单孢菌有效的药物。     

急诊科感染病原学分布及临床特点分析

目的 探讨急诊科感染的病原学分布和临床特点,为指导治疗提供依据.方法 对2007年度我院急诊科病房和呼吸科病房住院患者的细菌培养结果 及临床特点进行回顾性分析.结果 急诊科感染患者的基础病与呼吸科不同,住院时间短于呼吸科,使用抗生素的数量少于呼吸科.急诊科感染病原学分布与呼吸科相似,分离细菌前五位分别为鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌和凝固酶阴性葡萄球菌.结论 我院急诊科感染的特点表现为医院感染的特征.     

泌尿系统感染的病原学检查

1引言 泌尿系统感染是成年人最常见的感染性疾病之一.普通人群发病率为0 91%,女性人群为2.1%,育龄妇女为5%～6%,老年妇女为10%～12%,多为无症状性菌尿,而有临床症状的泌尿系统感染以育龄妇女(18～40岁)多见.至于成年男性,除非存在易感因素,一般极少发生泌尿系统感染,但随着年龄增长,前列腺疾病增加,男性泌尿系统感染的发生率逐渐升高.总的来说,男性泌尿系统感染的发生率远低于女性,男女之比约为1:10.     

肺部感染的病原学诊断方法

院内肺炎（ＮｏｓｏｃｏｍｉａｌＰｎｅｕｍｏｎｉａ）在病原学方面的诊断缺乏可靠的标准（ＧｏｌｄＳｔａｎｄａｒｄ），临床及放射学方面的诊断对治疗的指导很有限，特别是对于气管插管进行机械通气的病人来说，肺部的浸润性阴影可能是由于感染也可能是非感染因素造成的...     

Reducing the risk surgical site infection

Despite being largely preventable, surgical site infections continue to represent about a fifth of all healthcare-associated infections. This article examines the issues of detection and surveillance, and discusses the key interventions that can help to reduce the risk of these infections.ur     

Surgical site infection surveillance after open gastrectomy and risk factors for surgical site infection

Surgical site infection (SSI) surveillance was examined in gastric cancer patients who had undergone an open gastrectomy between 1997 and 2003 at Keio University Hospital in Tokyo, Japan. National Nosocomial Infections Surveillance (NNIS) reports and several studies have discussed SSI risk factors, but only open gastrectomy was analyzed by regression analysis. The purpose of this study was to examine these issues by performing a regression analysis for the prediction of SSI. SSI was defined by the surgical patient component according to the NNIS system (1999) produced by the Centers for Disease Control and Prevention. Patients undergoing an open gastrectomy were followed up and monitored for SSIs. Risk factors for SSI, after all factors were considered, were studied using single and multivariate analysis. The study enrolled 984 patients who had undergoing an open gastrectomy. Using multivariate and logistic regression analysis, the duration of the operation was identified as the only risk factor for SSI at open gastrectomy. Although numerous potential risk factors in surgical patients were examined, the duration of the operation was the only significant risk factor for SSIs after open gastrectomy. Part of this study was presented at the 76^th conference of the Infectious Disease Society An erratum to this article is available at .     

Causes, prevention and management of surgical site infection

Superficial surgical site infection (SSI) usually resolves quickly causing only short-term discomfort. However, SSI involving deeper tissues is a leading cause of morbidity and mortality and increases the overall cost of care. Although SSI commonly originates in the operating theatre, signs and symptoms of infection often do not appear until patients have been discharged from hospital. Nurses in a range of clinical settings are involved in the care of patients who either develop or are at risk of developing SSI and therefore need to know how to advise and manage these patients.     

Best-practice protocols: Preventing surgical site infection

Inconsistent application of infection control practices may contribute to differences in SSI rates and mortality of surgical patients.     

Caesarean section, surgical site infection and wound management

Surgical site infection (SSI) following caesarean section is a common cause of morbidity, with socioeconomic consequences for the woman and her family. This article describes the risk factors for SSI following caesarean section, including antibiotic prophylaxis, type of dressing, approach to wound closure, obesity and general health. Wound management and the information that women need to undertake safe and effective self-care once they leave hospital are also discussed. Recent research highlighting the extent of the problem and strategies for tackling it is reviewed.     

Nonconcordance with surgical site infection prevention guidelines and rates of surgical site infections for general surgical, neurological, and orthopedic procedures

Surgical site infection (SSI) is a common and preventable complication of surgery, but the relative importance of individual measures recommended by guidelines has not been determined. Elective general surgical, neurological, and orthopedic procedures requiring antibiotic prophylaxis from a 3-month period were retrospectively studied to determine concordance with SSI prevention guidelines and to identify factors which predicted the development of SSIs. A total of 216 surgeries were reviewed, with 18 SSIs (8.3%). A mean of 1.4 antibiotic prophylaxis errors per surgery were identified, with correct antibiotic type identified for 64%, antibiotic timing for 83%, supplemental antibiotic dosing for 34%, and antibiotic duration of less than 24 h for 44%. Normothermia was present in 79% of surgeries, and normoglycemia was present in 17%. Univariate analysis of the SSI rate identified four significant factors. Antibiotic prophylaxis for less than 24 h postoperatively (odds ratio [OR], 0.213; 95% confidence interval [95% CI]0.060 to 0.757) and neurosurgery (OR, 0.118; 95% CI, 0.15 to 0.903) correlated with a reduced risk of SSI. The mean number of prophylaxis errors (OR, 1.6; 95% CI, 1.02 to 2.4) and a duration of surgical drainage for more than 3 days (OR, 2.679; 95% CI, 1.009 to 7.113) predicted SSI. By multivariate analysis, errors in individual antibiotic prophylaxis measures were not significantly associated with SSI; however, the presence of more than two errors was significant (OR, 4.030; 95% CI, 1.018 to 15.96). A strong correlation was identified between the degree of concordance to SSI prevention guidelines and the SSI rate (P = 0.001, Mantel-Haenszel linear-by-linear association chi-square test).