摘要
目的:分析Ⅳ期压疮感染患者的临床特征、病原菌分布及耐药性,为医院感染的预防和控制工作提供客观依据。方法:选取2016年3月~2018年3月的45例Ⅳ期压疮合并感染患者作为病例组,选取同期45例Ⅳ期压疮未合并感染患者作为对照组,对两组患者的临床特征进行对比和分析,对病例组患者感染相关样本中的病原菌分布及耐药性进行检测和分析。结果:病例组患者的年龄、卧床时间均长于对照组,合并营养不良、糖尿病、外伤的比例均高于对照组,两组之间的差异均有统计学意义。检出56株病原菌,包括同一病例检出多株病原菌,其中,革兰阳性菌30株占53.57%,革兰阴性菌23株占41.07%,真菌3株占5.36%,金黄色葡萄球菌、大肠埃希菌、铜绿假单胞菌、表皮葡萄球菌为主要病原菌,构成比分别为23.21%、19.64%、16.07%、14.29%。主要革兰阳性菌对青霉素G、四环素、环丙沙星、磺胺甲噁唑/甲氧苄啶的耐药率较高,对替考拉宁、左氧氟沙星的耐药率较低,未检出对万古霉素耐药的革兰阳性菌。主要革兰阴性菌对庆大霉素、利福平、磺胺甲噁唑/甲氧苄啶的耐药率较高,对亚胺培南、美罗培南、环丙沙星的耐药率较低。结论:Ⅳ期压疮合并感染患者具有高龄、卧床时间长、营养状态不佳、合并症较多的临床特征,病原菌以金黄色葡萄球菌等革兰阳性菌为主,这些病原菌的耐药性较强,临床医生应根据上述特征合理制订感染预防和控制方案,以达到提高疗效、促进康复和改善预后的目的。
Objective To analyze the clinical characteristics,the distribution and drug resistance of the pathogenic bacteria of the patients with four stage pressure ulcer complicated infections to provide an objective basis for the prevention and control of nosocomial infections.Methods 45 cases of patients with four stage pressure ulcer complicated with infections from March of 2016 to March of 2018 were selected as the case group,and 45 cases of the patients with four stage pressure ulcer excluded of infections during the same period were selected as the control group.The clinical characteristics of the patients in the two groups were compared and analyzed.The distribution and the drug resistance of the pathogenic bacteria in the infection related samples of the patients in the case group were detected and analyzed.Results The age and the bed rest time of the patients in the case group were longer than those in the control group,and the proportions of patients complicated with malnutrition,diabetes or trauma were higher than those in the control group.The differences between the two groups were statistically significant.56 strains of pathogenic bacteria were detected,in which,30 strains were Gram-positive bacteria accounting for 53.57%,23 strains were Gram-negative bacteria accounting for 41.07%,3 strains were fungi accounting for 5.36%.Staphylococcus aureus,Escherichia coli,Pseudomonas aeruginosa and Staphylococcus epidermidis were the main pathogenic bacteria,and the constituent ratios were 23.21%,19.64%,16.07%,14.29%respectively.The drug resistant rates of the main Gram-positive bacteria to penicillin G,tetracycline,ciprofloxacin,sulfamethoxazole/trimethoprim were higher,the drug resistant rates to teicoplanin,levofloxacin were lower.No Gram-positive bacteria resistant to vancomycin was detected.The resistance rates of the main Gram-negative bacteria to gentamicin,rifampicin,sulfamethoxazole/trimethoprim were higher,and the resistance rates to imipenem,meropenem and ciprofloxacin were lower.Conclusions The patients with four stage pressure ulcer complicated with infections have the clinical features of high age,long bed rest time,poor nutritional status and more complications.The pathogenic bacteria are mainly Gram-positive bacteria such as Staphylococcus aureus,and the resistance of these pathogenic bacteria is strong.The clinicians should formulate the prevention and control scheme for infections according to the above characteristics in order to improve curative effects,promote rehabilitation and improve prognosis.
作者
符秀梅
钟书辉
薛根山
周淑萍
Fu Xiu-mei;Zhong Shu-hui;Xue Gen-shan;Zhou Shui-ping(Department of Internal Medicine,Cadre Sanatorium of Hainan&Geriatric Hospital of Hainan,Haikou 571100,China;Department of Critical Medicine,Cadre Sanatorium of Hainan&Geriatric Hospital of Hainan,Haikou 571100,China;Laboratory,Cadre Sanatorium of Hainan&Geriatric Hospital of Hainan,Haikou 571100,China;Department of Internal Medicine,Halnan General Hospltal,Haikou 570311,China)
出处
《湖南师范大学学报（医学版）》
2020年第2期85-89,共5页
Journal of Hunan Normal University(Medical Sciences)
关键词
Ⅳ期压疮
医院感染
临床特征
病原菌分布
耐药性
four stage pressure ulcer
nosocomial infection
clinical characteristics
distribution of pathogenic bacteria
drug resistance
