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目的探讨神经内科住院患者医院感染(NI)的特点,分析引起NI的危险因素,寻找控制NI的措施。方法对2006年1月～2007年12月间,1966例住院患者NI情况进行前瞻性加回顾性调查分析。结果医院感染226例,医院感染率11.50%;NI248例次;感染多发于脑卒中患者,以脑梗死、脑出血为主,其构成比分别占44.25%和39.38%;感染部位分布以上、下呼吸道、泌尿道和胃肠道感染最常见,分别占62.83%、15.49%、20.35%和4.42%;病原菌以肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌和铜绿假单胞菌为主,对亚胺培南、头孢哌酮/舒巴坦、头孢吡肟和阿米卡星耐药率最低,而对常见的抗菌药哌拉西林、诺氟沙星、头孢曲松等耐药率较高。患者病情严重程度、侵入性操作、住院时间、年龄等是引起NI的主要危险因素。结论神经内科患者NI发病率较高,获得途径以内源性为主,针对主要危险因素进行综合管理、重点监控,感染患者及时明确病原菌,根据药敏结果合理用药,一定能降低NI的发病率。
Objective To investigate the characteristics of nosocomial nosocomial infection (NI) in neurology department, analyze the risk factors of NI and find out the measures to control NI. Methods From January 2006 to December 2007, 1966 inpatients with NI were retrospectively analyzed retrospectively. Results 226 cases of nosocomial infection, nosocomial infection rate of 11.50%; NI248 cases; infection in patients with stroke, cerebral infarction, cerebral hemorrhage, accounting for 44.25% and 39.38%, respectively; infection site distribution above and below the lower respiratory tract , Urinary tract and gastrointestinal tract infections were the most common, accounting for 62.83%, 15.49%, 20.35% and 4.42% respectively. The pathogenic bacteria were Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa The main, the lowest rate of resistance to imipenem, cefoperazone / sulbactam, cefepime and amikacin, while the common antibacterial drugs piperacillin, norfloxacin, ceftriaxone resistance Higher rate. The severity of the patient’s condition, invasive procedures, length of stay, and age are the major risk factors for NI. Conclusion The incidence of NI in neurology patients is high, the way of endogenous access is mainly based on the comprehensive management of key risk factors, and the key surveillance and infection of patients with timely identification of pathogens, rational use of drugs based on susceptibility results will be able to reduce the incidence of NI.