心胸外科ICU患者术后感染及相关因素分析

Abstract
Figure/Table
References (26)
Related Citation (7)

Download: PDF (689 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate postoperative infection and related risk factors in patients with cardiothoracic surgery ICU. Methods A retrospective analysis was made on 240 patients admitted to ICU of Cardiothoracic Surgery, First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from July 2016 to July 2018. The clinical data (including age, cardiopulmonary bypass, time of tracheal intubation, time of drainage tube placement, time of catheter placement, operation time, blood transfusion, time of deep vein catheterization) and monitoring funds of nosocomial infection were collected. The data were systematically investigated and analyzed. Results Hospital infection occurred in 38 of 240 patients, with an infection rate of 15.83%. The most common site of infection is the respiratory tract, a total of 25 cases. Fifty-nine strains of pathogens were detected, including 34 Gram-negative bacteria, 15 Gram-positive bacteria, and 10 fungi. Multivariate Logistic regression analysis showed that age, extracorporeal circulation, tracheal intubation time, and drainage tube placement time were independent risk factors for postoperative infection, and the differences were statistically significant (P < 0.05). The main Gram-negative bacteria were Acinetobacter baumannii and Klebsiella pneumoniae, which were more resistant to Cefixime, Imipenem, Ciprofloxacin, Gentamicin, Ampicillin and Aztreonam. Gram-positive bacteria were mainly Staphylococcus haemolyticus, Staphylococcus epidermidis and Staphylococcus hemorrhagicus. Gram-positive bacteria mainly include Staphylococcus haemolyticus, Staphylococcus epidermidis, and Staphylococcus aureus, which were sensitive to Vancomycin and Linezolid, but they were resistant to Amoxicillin, Azithromycin, Deoxycephalosporin, Meropenem, and Cefixime, with higher resistance rate. Conclusion The infection rate of ICU patients in cardiothoracic surgery is high, and there are many factors leading to infection. The clinical intervention should be given. The drug resistance rate of pathogenic bacteria is relatively high. Clinical attention should be paid to the detection of pathogenic microorganisms, and rational use of antibiotics should be based on the results of bacterial culture and drug sensitivity.

Key words： Cardiothoracic surgery ICU Postoperative infection Relevant factor

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LIU Danwei NI Guangsheng YANG Jin XU Zhaojun

Cite this article:

LIU Danwei NI Guangsheng YANG Jin XU Zhaojun. Analysis of postoperative infection and related factors in patients with cardiothoracic surgery ICU[J]. 中国医药导报, 2019, 16(14): 113-116.

URL:

http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I14/113

[1] Gelijns AC，Moskowitz AJ，Acker M，et al. Management practices and major infections after cardiac surgery [J]. J Am Coll Cardiol，2014，64（4）：372-381.
[2] 李丽，马育璇.心脏手术患者术后肺部感染的研究进展[J].吉林医学，2016，37（11）：2811-2815.
[3] Perrault LP，Kirkwood KA，Chang H，et al. A Prospective MultiInsti-tutional Cohort Study of Mediastinal Infections After Cardiac Operations [J]. Ann Thorac Surg，2018，105（2）：461-468.
[4] 陈东卫.重症监护室医院感染目标性监测[J].临床医学研究与实践，2018，3（15）：48-49.
[5] 李军民，胡云芝，冯陆，等.心脏术后医院感染的病原菌分布与耐药性分析[J].中华医院感染学杂志，2015，25（1）：72-74.
[6] 周素敏，罗秀娟.胸外科术后患者医院感染的调查分析及预防[J]，中华医院感染学杂志，2012，22（24）：5535-55 37.
[7] 周丹，刘彬，庾华东，等.心脏外科患者感染病原菌的耐药性监测分析[J].中华医院感染学杂志，2017，27（11）：2520-2523.
[8] Eton V，Sinyavskaya L，Langlois Y，et al. Effect of Pre-Operative Use of Medications on the Risk of Surgical Site Infections in Patients Undergoing Cardiac Surgery [J]. Surg Infect（Larchmt），2016，17（5）：557-562.
[9] 谭昆，魏诗晴，徐敏，等.心脏大血管术后患者医院感染特征及相关因素分析[J].中华医院感染学杂志，2018，28（8）：1216-1219.
[10] 尤颢，廖崇先，杨谦，等.成人体外循环心脏术后手术部位感染的危险因素分析[J].中华医院感染学杂志，2011， 21（5）：894-896.
[11] 陈航.胸外科术后患者呼吸道感染的易感因素及治疗效果[J].医疗装备，2016，29（22）：115-116.
[12] 程丽峰，阿依古丽，李军，等.心脏外科患者手术部位感染的危险因素[J].中国感染控制杂志，2017，16（1）：62-65.
[13] 桂赛银，丁汀，裘岚，等.心脏手术患者切口感染与手术室相关因素分析[J].中华医院感染学杂志，2014，24（24）：6195-6197.
[14] 陈鸣敏.心外科手术术后医院感染危险因素分析[J].中华医院感染学杂志，2013，23（3）：547-548，567.
[15] 王学斌，姚滨，张勇，等.心脏术后医院感染发生现状及高危因素研究[J].中华医院感染学杂志，2017，27（7）： 1558-1560，1571.
[16] 彭丛兄，彭根英，吴旭辉，等.胸外科患者术后医院感染病原菌分布及药敏分析[J].中华医院感染学杂志，2014， 24（17）：4208-4210.
[17] 王涛，王瑞兰.鲍曼不动杆菌医院感染相关危险因素及预防[J].中国感染与化疗杂志，2015，15（1）：81-83.
[18] 肖淑珍，徐桂婷，方洁，等.鲍曼不动杆菌耐药性与抗菌药物使用情况的相关性分析[J].中国感染与化疗杂志，2013，13（6）：446-449.
[19] 赵书平，李厚景，张开刚.医院感染肺炎克雷伯菌分布及耐药性分析[J].中华医院感染学杂志，2014，24（13）： 3135-3136，3166.
[20] 江丹英，林雪峰，王兵勇，等.医院感染肺炎克雷伯菌的临床分布及耐药性分析[J].中国现代医生，2015，53（34）：117-120.
[21] 杭欣，张波.耐碳青霉烯肺炎克雷伯菌易感因素分析[J].山西医科大学学报，2016，47（5）：450-454.
[22] 刘金花，朱虹，余萍.某中医院2014~2016年医院感染现患率调查分析[J].中国医药导报，2018，15（20）：177-180.
[23] 杨蕊，贺可心，张颖，等.过程质量监控对住院危重患者医院感染的影响[J].中国医药科学，2018，8（13）：169-171.
[24] 初瑞雪，刘信成，孟卫东，等.某三甲医院6637株医院感染病原菌分布及耐药性分析[J].中国现代医生，2018，56（12）：116-119.
[25] 宋萍，王倩，纪英.鱼骨柏拉图在消毒供应中心医院感染管控中的应用效果[J].中国医药导报，2017，14（13）：162-166.
[26] 黄小玲，魏伟华，胡洁云，等.手术室细节护理降低医院感染效果评价[J].中国医药科学，2017，7（7）：152-154.