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目的对骨科无菌手术患者的感染主要部位、病原菌分布情况以及耐药性进行分析,总结骨科患者感染的特点,进而得出合理用药依据。方法对2014年6月-2016年6月来本院接受无菌手术治疗的2 112例骨科住院患者的临床资料进行分析。结果 2 112例骨科无菌手术患者出现医院感染为100例,患者感染率为4.73%。其中患者的医院感染例次110例次。常见的感染部位依次为手术切口(占44.5%)、泌尿道(占27.3%)以及下呼吸道(占10.0%)。就病原菌株数来看,革兰阴性菌分布最多(占53.3%),其次为革兰阳性菌(占41.9%),真菌最少(占4.8%)。根据药敏试验来看,主要病原菌对常用抗菌药具有较高的耐药率,其中革兰阳性菌对万古霉素的耐药率最低,革兰阴性菌对亚胺培南的耐药率最低。结论接受无菌手术的骨科患者发生切口感染的概率较高,且病原菌感染情况较复杂,医护人员需合理使用抗菌药物,从源头上预防患者感染的发生,降低患者的感染率。
Objective To analyze the main parts of infection, the distribution of pathogens and drug resistance in patients with orthopedic surgery, summarize the characteristics of patients with orthopedic infection, and then draw a reasonable basis for medication. Methods Clinical data of 2 112 orthopedic inpatients who underwent aseptic surgery in our hospital from June 2014 to June 2016 were analyzed. Results Two hundred and thirteen cases of nosocomial infection in orthopedic surgery were diagnosed as nosocomial infection and the infection rate was 4.73%. Among them, the number of nosocomial infections was 110 cases. Common infection sites were surgical incision (44.5%), urinary tract (27.3%) and lower respiratory tract (10.0%). In terms of the number of pathogenic bacteria, Gram-negative bacteria were most widely distributed (53.3%), followed by Gram-positive bacteria (41.9%) and fungi (4.8%). According to the drug susceptibility test, the major pathogens have higher resistance rates to common antibacterials, of which Gram-positive bacteria have the lowest rates of resistance to vancomycin and the lowest rates of resistance to imipenem of Gram-negative bacteria . Conclusion The incidence of incision infection in orthopedic patients undergoing aseptic surgery is high, and the pathogen infection is complicated. Health care workers need to use antimicrobial drugs reasonably to prevent the occurrence of infection and reduce the infection rate of patients.