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目的:分析胸外科患者术后医院感染的病原菌分布及危险因素,为防控医院感染提供数据支持。方法:选择2014年1月至2015年5月医院接受胸外科手术治疗的患者284例进行研究。回顾性分析284例患者的临床病历数据资料以及细菌培养与鉴定的结果,分析医院感染的主要部位及病原菌分布,以及产生医院感染的危险因素。结果:284例患者共有82例发生医院感染,感染率是28.87%,感染部位以呼吸系统为主,占56.10%;检出病原菌88株,革兰阴性菌71株,占80.68%,以铜绿假单胞菌为主,占30.68%。革兰阳性菌17株,占19.32%,以金葡菌为主,占9.09%。单因素分析发现,胸外科术后医院感染与年龄、手术时间、住院时间及糖尿病史有关,差异有统计学意义(P<0.05);Logistic回归分析显示,年龄≥60岁、手术时间>2 h、住院时间>15 d以及有糖尿病史是胸外科术后医院感染的危险因素。结论:胸外科患者术后医院感染的病原菌分布以铜绿假单胞菌与金葡菌为主,应重点防范影响感染的危险因素,以降低感染率。
Objective: To analyze the distribution and risk factors of pathogenic bacteria in postoperative nosocomial infection in thoracic surgery and provide data support for the prevention and control of nosocomial infection. Methods: A total of 284 patients undergoing thoracic surgery from January 2014 to May 2015 in our hospital were selected for study. A retrospective analysis of 284 cases of clinical medical records data and bacterial culture and identification of the results of analysis of the main parts of the hospital infection and distribution of pathogens, and the risk of nosocomial infections. Results: A total of 82 cases of nosocomial infection occurred in 284 patients, the infection rate was 28.87%. The infected area was mainly respiratory system, accounting for 56.10%. 88 pathogenic bacteria were detected, 71 strains were gram-negative bacteria, accounting for 80.68% Aeromonas dominated, accounting for 30.68%. Gram-positive bacteria 17 strains, accounting for 19.32%, mainly Staphylococcus aureus, accounting for 9.09%. Univariate analysis showed that the incidence of nosocomial infection after thoracic surgery was related to age, operation time, hospital stay and history of diabetes mellitus (P <0.05). Logistic regression analysis showed that age ≥60 years and operation time> 2 h , Hospital stay> 15 days, and diabetes mellitus were risk factors for nosocomial infections after thoracic surgery. Conclusion: The pathogen distribution of postoperative nosocomial infection in patients with thoracic surgery is mainly Pseudomonas aeruginosa and Staphylococcus aureus. Risk factors affecting infection should be focused on reducing the infection rate.