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目的:了解妇科住院患者医院感染的的发生情况、特点、病原菌菌群分布以及相关危险因素。方法:回顾性调查分析7 966例妇科住院患者病历资料。结果:7 966例发生医院感染228例次,发生率为2.86%。感染部位前3位依次为上呼吸道(26.32%)、泌尿道(25.44%)、手术切口部位(23.25%)。感染菌株前5位依次为大肠埃希菌(25.96%,27/104)、白色念珠菌(23.08%,24/104)、肠球菌(11.04%,12/104)、阴道加德纳菌(10.58%,11/104)、副流感嗜血杆菌(8.65%,9/104)。妇科住院患者医院感染危险因素包括年龄(≥50岁)、妊娠、住院时间(≥9天)、侵入性操作、抗生素应用(≥7天)、化疗、手术时间(≥3小时)、手术种类等。结论:妇科住院患者医院感染有其自身特点,临床中应重视健康教育和心理护理,提高手术技巧,及时采集标本进行细菌学监测,指导临床正确合理使用抗菌药物,以缩短住院时间,使患者尽早康复。
Objective: To understand the occurrence and characteristics of nosocomial inpatients with gynecological infection, the distribution of pathogenic bacteria and the related risk factors. Methods: A retrospective analysis of 7 966 cases of gynecological inpatients records. Results: There were 228 cases of hospital infection in 7 966 cases, the incidence was 2.86%. The top three infected sites were upper respiratory tract (26.32%), urinary tract (25.44%) and surgical incision site (23.25%). Escherichia coli (25.96%, 27/104), Candida albicans (23.08%, 24/104), Enterococcus (11.04%, 12/104), Gardnerella vaginalis (10.58 %, 11/104), Haemophilus parainfluenzae (8.65%, 9/104). Risk factors for nosocomial hospital-acquired nosocomial infections include age (≥50 years), pregnancy, hospital stay (≥9 days), invasive procedures, antibiotic use (≥7 days), chemotherapy, duration of surgery (≥3 hours), type of surgery . Conclusion: Inpatients with gynecological inpatients have their own characteristics of hospital infection, clinical education should pay attention to health education and psychological care, improve surgical skills, timely collection of specimens for bacteriological monitoring, and guidance of clinical rational use of antimicrobial agents to shorten the hospital stay so that patients as soon as possible Rehabilitation.