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目的探讨慢性乙型肝炎患者医院病原菌感染的临床特点及病原学分析,为临床预防医院感染提供有利依据。方法选取2010年12月-2013年12月慢性乙型肝炎患者240例,依据不同年龄段进行分组,对比其感染率,通过菌株培养及鉴定判断引起感染的病原菌分布,分析感染的临床特点,明确慢性乙型肝炎患者易感染部位。结果 240例慢性乙型肝炎患者发生医院感染73例、84例次,感染率30.42%、例次感染率35.00%;73例感染患者中52例为多重感染,共分离出病原菌131株,其中革兰阴性菌占33.59%、革兰阳性菌占14.50%、真菌占51.91%;医院感染部位主要以腹腔为主占38.10%,其次为下呼吸道占15.48%;引起52例患者病原菌感染的因素主要为抗菌药物的滥用。结论感染是慢性乙型肝炎患者最多见的并发症之一,也是肝衰竭最终导致多脏器功能衰竭的始动原因,因此临床要加强慢性乙型肝炎患者医院感染相关危险因素的控制,依据病原学分析合理应用抗菌药物,积极预防与治疗感染是提高重型肝炎存活率的重要环节。
Objective To investigate the clinical characteristics and etiological analysis of nosocomial pathogen infection in patients with chronic hepatitis B and to provide a good basis for clinical prevention of nosocomial infection. Methods A total of 240 patients with chronic hepatitis B from December 2010 to December 2013 were selected and divided into groups according to different age groups. The infection rate was compared with each other. The distribution of pathogens causing infection was determined by strain culture and identification. The clinical features of the infection were analyzed. Chronic hepatitis B patients prone to infection sites. Results Of the 240 patients with chronic hepatitis B, 73 cases were hospitalized with infection in 84 cases, the infection rate was 30.42% and the infection rate was 35.00%. Among the 73 infected patients, 52 cases were multiple infections and 131 strains were isolated, of which 131 Gram-positive bacteria accounted for 33.59%, Gram-positive bacteria accounted for 14.50% and fungi accounted for 51.91%. The main infection in the hospital was mainly abdominal cavity (38.10%), followed by lower respiratory tract (15.48%). The main causes of pathogen infection in 52 patients were Antibacterial abuse. Conclusion Infection is one of the most common complication of chronic hepatitis B patients and the initiating cause of liver failure eventually leading to multiple organ failure. Therefore, it is necessary to strengthen the control of the risk factors of nosocomial infection in patients with chronic hepatitis B according to the pathogen Analysis of rational use of antimicrobial agents, active prevention and treatment of infection is an important part of improving the survival rate of severe hepatitis.