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目的探讨妊娠期孕妇围产期医院感染临床特征及病原菌耐药性,为控制医院围产期感染提供依据。方法回顾性分析2011年11月-2013年11月医院分娩的1 800例产妇临床资料,统计医院感染发生率、感染部位、病原菌分布及对抗菌药物耐药率;采用SPSS 21.0统计软件进行分析。结果 1 800例产妇发生医院感染32例,感染率1.8%;医院感染主要发生部位为呼吸道8例占25.0%,手术切口6例占18.8%,会阴伤口5例占15.6%,泌尿道5例占15.6%;阴道手术产者医院感染发生率显著高于阴道自然分娩和剖宫产(P<0.05);32例医院感染患者分离出71株病原菌,其中革兰阳性菌27株占38.0%、革兰阴性菌41株占57.8%、真菌3株占4.2%;革兰阳性菌对万古霉素、利福平、利奈唑胺耐药率为0。结论妊娠期孕妇产后医院感染病原菌以革兰阴性菌为主,了解产妇医院感染临床特征及病原菌耐药率,并制定预防措施降低产妇医院感染率,从而提高产妇及新生儿预后。
Objective To investigate the clinical characteristics and pathogens resistance of perinatal nosocomial infection in pregnant women during pregnancy and provide basis for controlling perinatal infection in hospitals. Methods The clinical data of 1,800 mothers delivered from November 2011 to November 2013 in our hospital were retrospectively analyzed. The incidence of nosocomial infection, the distribution of infection, the distribution of pathogens and the rate of antibacterial drug resistance were calculated. SPSS 21.0 software was used to analyze the data. Results The incidence of nosocomial infection in 1 800 maternal cases was 32%, and the infection rate was 1.8%. The major sites of nosocomial infection were respiratory tract 8 cases 25.0%, surgical incision 6 cases 18.8%, perineal wound 5 cases 15.6% and urinary tract 5 cases 15.6%. The incidence of nosocomial infection in vaginal surgery was significantly higher than that in spontaneous vaginal delivery and cesarean section (P <0.05). Seventy-one pathogens were isolated from 32 patients with nosocomial infections, of which 27 were gram-positive bacteria accounting for 38.0% 41 strains of blue-negative bacteria accounted for 57.8%, fungi 3 strains accounted for 4.2%; Gram-positive bacteria vancomycin, rifampicin, linezolid resistance rate of 0. Conclusions The main pathogens of postpartum nosocomial infection during pregnancy in pregnant women are Gram - negative bacteria. The clinical characteristics of maternal nosocomial infection and the rate of drug resistance of pathogens are known. And preventive measures are taken to reduce the rate of nosocomial infection and improve the prognosis of maternal and newborn infants.