重型肝炎患者医院内腹腔感染的特点和发病因素分析

目的探讨重型肝炎患者医院内腹腔感染的临床特点和防治对策。方法回顾性调查2001年10月-2004年9月在某院感染科住院的重型肝炎患者的病历资料。结果3年内该科收治的80例重型肝炎患者中有46例(57．50％)发生医院内腹腔感染。腹腔感染者行腹水细菌培养有14例获阳性结果，其中5例为多种细菌感染，菌种以条件致病菌为主，耐药率高。伴有腹腔感染者亦常见其他部位感染及合并真菌感染，肝性脑病和肝肾综合征的发生率高，治疗效果差；病死率(56．52％)明显高于无腹腔感染的重型肝炎患者(29．41％)。结论重型肝炎患者易发生医院内腹腔感染，病原菌以条件致病菌为主。腹腔感染常与其他部位感染或并发症并存，病死率高；预防和治疗需采取综合措施。

Characteristics of nosocomial abdominal cavity infection in patients with hepatitis gravis

Objective To study the clinical features and preventive measures of nosocomial abdominal cavity infection (NACI) in patients with hepatitis gravis. Methods Clinical data about inpatients with hepatitis gravis who were hospitalized in a infectious diseases department from October 2001 to September 2004 were investigated retrospectively. Results Forty-six of 80 (57.50%) patients with hepatitis gravis developed NACI, bacteria were isolated from ascites in 14 of 46 patients, 5 cases were multiple bacteria infection. Most isolated bacteria were opportunistic pathogens with high antimicrobial resistance. Patients with NACI were also associated with the other site infection or fungi infection. The occurrence of hepatic encephalopathy and hepato-renal syndrome was common and fatality rate (56.52%) was much higher than that (29.41%) in patients without NACI. Conclusion NACI is a common complication in patients with hepatitis gravis and opportunistic bacteria are main pathogens. NACI is often associate with other infections, the fatality rate is high. Comprehensive measures are necessary to the prevention and treatment.