摘要
目的探讨脑梗死患者褥疮感染的病原学及其护理干预的应用效果,为临床上提高脑梗死患者的护理效果提供参考依据。方法选取医院2012年10月-2015年9月脑梗死合并褥疮感染的患者156例,搜集其感染部位分泌物标本进行培养,采用法国生物梅里埃公司Vitek-2Compact型细菌鉴定及药敏性分析仪进行鉴定分析,根据药敏试验结果制定其预防策略,进行针对性治疗,并辅以优质的护理干预。结果脑梗死合并褥疮感染患者标本中共分离出病原菌148株,其中革兰阴性菌76株占51.35%,以铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌为主,革兰阳性菌60株占40.54%,以金黄色葡萄球菌、粪肠球菌、表皮葡萄球菌为主,真菌12株占8.11%,以白色念珠菌为主;革兰阴性菌中铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌对青霉素、头孢呋辛、头孢噻肟、头孢哌酮、阿米卡星、妥布霉素等抗菌药物耐药率高,对亚胺培南、美罗培南等抗菌药物较敏感;革兰阳性菌中金黄色葡萄球菌、粪肠球菌及表皮葡萄球菌对红霉素、青霉素及左氧氟沙星等抗菌药物耐药率较高,但对替考拉宁较敏感。结论脑梗死合并褥疮感染的患者病原菌以革兰阴性菌为主,耐药性较强,临床治疗中应以病原菌特点及药敏结果为依据合理应用抗菌药物,以减少新耐药菌株的形成,对褥疮感染的患者进行有针对性的优质护理可以降低医院感染的发生,提高临床疗效。
OBJECTIVE To explore the etiology of bedsore infections in cerebral infarction patients and observe the effects of nursing interventions so as to improve the clinical nursing effects of the cerebral infarction patients.METHODS A total of 156 cerebral infarction patients complicated with bedsore infections who were treated in hospitals from Oct 2012 to Sep 2015 were enrolled in the study,then the secretion specimens were collected from the infection sites and cultured,the isolated pathogens were identified by using Vitek-2Compact bacterial identification system of BioMérieux,France and drug susceptibility analyzer,the prevention strategies were formulated based on results of drug susceptibility testing,the targeted therapy was conducted,and the high-quality nursing interventions were taken.RESULTS Totally 148 strains of pathogens were isolated from the cerebral infarction patients complicated with bedsore infections,including 76（51.35%）strains of gram-negative bacteria,60（40.54%）strains of gram-positive bacteria,and 12（8.11%）strains of fungi;the Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,and Acinetobacter baumannii were dominant among the gram-negative bacteria;the Staphylococcus aureus,Enterococcus faecalis,and Staphylococcus epidermidis were the major species of the gram-positive bacteria;the Candida albicans was the predominant species of the fungi.Among the gram-negative bacteria,the P.aeruginosa,K.pneumoniae,and E.coli were highly resistant to penicillin,cefuroxime,cefotaxime,cefoperazone,amikacin,and tobramycin but were susceptible to imipenem and meropenem.Among the gram-positive bacteria,the S.aureus,E.faecalis,and S.epidermidis were highly resistant to erythromycin,penicillin,and levofloxacin but were susceptible to teicoplanin.CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the cerebral infarction patients complicated with bedsore infections and are highly drug-resistant.It is necessary for the hospital to reasonably use antibiotics based on the characteristics of pathogens and the results of the drug susceptibility testing so as to reduce novel drug-resistant strains and conduct targeted,high-quality nursing for the patients with bedsore infections so as to reduce the incidence of nosocomial infections and improve the clinical efficacy.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第17期3966-3968,共3页
Chinese Journal of Nosocomiology
基金
江苏省科学基金资助项目(81202958)
关键词
脑梗死
褥疮感染
病原菌
耐药性
护理干预
Cerebral infarction
Bedsore infection
Pathogen
Drug resistance
Nursing intervention
