神经内科多重感染患者病原学及其病房环境特征的分析

目的 通过对神经内科住院患者多重感染的病原学及其病房环境主要微生物学特征的分析,有针对性地进行预防与控制医院感染的发生.方法 选取2009年4月-2010年9月某三甲医院神经内科住院患者为监测对象,对发生感染患者进行病原学检查,并对其所住病房的空气和床单位等进行微生物学监测.结果 神经内科住院患者2481例中感染110例占4.43％,多重感染42例,占感染患者的38.18％;以下呼吸道感染为主占76.92％;检出病原菌主要为铜绿假单胞菌占24.73％、肺炎克雷伯菌占19.35％;病房空气和床单位中以藤黄微球菌、表皮葡萄球菌等革兰阳性球菌为主,并检测到大肠埃希菌、鲍氏不动杆菌等少量条件致病菌;其中3例多重感染患者,在病房的空气、枕头、棉被中同时检测出表皮葡萄球菌,1例多重感染患者同时检测到大肠埃希菌.结论 神经内科多重感染患者的病原菌和病房空气及床单位中微生物分布具有明显的一致性,病房空气及床单位环境中的微生物是医院感染的主要病原菌.

Etiology and indoor environment characteristics of multiple-infection patients in neurological department

OBJECTIVE To prevent and control nosocomial infection by analyzing characteristics of etiology and microbiology in indoor environment of patients complicating multiple infections in neurological department.METHODS The inpatients in neurological department in a hospitals from Apr 2009 to Sep 2010 were studied.The etiological examination for patients with infection and microbiological monitoring for the air and drapes(pillow,quilt) were performed.RESULTS Of 2481 inpatients in department of neurology,totally 110 cases were found with infection,and the infection rate was 4.43%.Of the 110 cases,42 cases were found with multiple infections,accounting for 38.18% of the infection patients.Low respiratory tract(76.92%) was the major infection site.The main pathogens were Pseudomonas aeruginosa(24.73%) and Klebsiella pneumonia(19.35%).Pathogens in air,bed units(pillow and quilt) in ward were mainly Micrococcus leteus and Staphylococcus epidermidis(Gram-positive bacteria),and a few opportunistic bacterias such as A.baumannii and Escherichia coli were found.S.epidermidis was found in the ward environment(air,pillow and quilt) of 3 cases with multiple infections,and E.coli was detected in 1 case with multiple infections.CONCLUSION Pathogens in patients with multiple infections are identical with that in ward air and bed units in neurological department.Microbes in ward air and bed unit are important for nosocomial infection.