心血管外科ICU66例心脏移植患者医院感染发病率

摘要

Objective To understand the status and pathogenic characteristics of healthcare-associated infection (HAI)in cardiovascular surgical intensive care unit (ICU)patients undergoing heart transplantation.Methods Pa-tients who underwent heart transplantation in a hospital between July 1 ,2013 and June 30,2014 were performed targeted monitoring.Results Of 66 patients undergoing heart transplantation,16 developed 18 times of HAI,inci-dence of HAI was 24.24%.Incidence of HAI and ventilator-associated pneumonia(VAP)in patients undergoing heart transplantation were both higher than non-transplantation patients (24.24% vs 6.24%,χ2 =33.718;7.58%vs 1 .72%,χ2 =12.199,respectively,both P <0.001 ).The infection tyes were as follows:lower respiratory tract infection(n=7),VAP (n=6),bacteremia (n=3),superficial incision infection (n =1 ),as well as skin and soft tissue infection (n = 1 ). The isolated pathogens were fungus (n = 8 ),Klebsiella pneumoniae (n = 3 ), Staphylococcus aureus (n=2),Acinetobacter baumannii (n=2),Enterobacter cloacae (n=1 ),Acinetobacter hae-molyticus (n=1 ),and Citrobacter freundii (n =1 ).Conclusion Incidence of HAI is high in patients undergoing heart transplantation,the main infection type is lower respiratory tract infection,the major pathogen is fungus.%目的：了解心血管外科重症监护病房（ICU）心脏移植患者医院感染情况和病原学特点。方法对2013年7月1日—2014年6月30日某医院心脏移植住院患者进行目标性监测。结果心血管外科 ICU 66例心脏移植患者共发生医院感染16例（18例次），ICU 医院感染发病率为24．24％。其医院感染发病率（24．24％）、VAP 发病率（7．58％）均高于非移植患者（分别为6．24％、1．72％）（χ2值分别为33．718、12．199，均 P ＜0．001）。其中下呼吸道7例次，呼吸机相关肺炎（VAP）6例次，菌血症3例次，表浅切口和皮肤软组织感染各1例次。分离病原菌：真菌8株，肺炎克雷伯菌3株，金黄色葡萄球菌和鲍曼不动杆菌各2株，阴沟肠杆菌、溶血不动杆菌和弗劳地柠檬酸杆菌各1株。结论心脏移植患者医院感染发病率较高，主要感染类型为下呼吸道感染，主要病原体为真菌。