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目的了解创伤专科医院颅脑外伤患者医院感染情况及其病原菌种类与耐药性情况,以指导临床合理选择抗菌药物。方法通过回顾性调查和病原菌检测方法,对某创伤专科医院住院颅脑外伤患者医院感染发生率和送检病原学标本检测结果进行统计分析。结果共调查该医院住院颅脑外伤患者1 602例,发生医院感染202例,感染率为12.6%。颅脑外伤患者医院感染部位中,下呼吸道感染占60.2%,其次为泌尿道、上呼吸道和创口感染,构成比分别为12.34%、11.96%和9.36%。从感染患者送检标本中共检出病原菌272株,以铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌和粪肠球菌分居前4位。革兰阴性病原菌对临床常用抗菌药物普遍耐药,对碳青霉烯类也出现了耐药菌株。结论创伤专科医院颅脑外伤患者医院感染发病率明显高于其他科室,感染病原菌耐药严重,应当加强耐药菌监测和药敏试验。
Objective To understand the prevalence of nosocomial infections and the types and drug resistance of patients with traumatic brain injury in trauma hospitals so as to guide clinical rational selection of antimicrobial agents. Methods The retrospective survey and pathogen detection methods were used to analyze the incidence of nosocomial infection and pathogen detection in traumatic hospital patients with traumatic brain injury. Results A total of 1 602 hospitalized patients with craniocerebral trauma were investigated in this hospital. 202 cases of nosocomial infection occurred and the infection rate was 12.6%. Among the patients with craniocerebral trauma, lower respiratory tract infection accounted for 60.2%, followed by urinary tract, upper respiratory tract and wound infection, with the proportions of 12.34%, 11.96% and 9.36%, respectively. A total of 272 pathogenic bacteria were detected from the infected patients, and the top 4 were Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli and Enterococcus faecalis. Gram-negative pathogens are generally resistant to common clinical antibiotics, and resistant strains to carbapenems. Conclusion The incidence of nosocomial infection in patients with traumatic brain injury in traumatic hospital was significantly higher than that in other departments. The infection of pathogens was serious, and the monitoring of drug-resistant bacteria and susceptibility testing should be strengthened.