院内感染复数菌败血症的临床和耐药分析

目的 探讨院内感染复数菌败血症的临床特征、危险因素、致病菌分布及耐药情况。方法 回顾性分析1970～2004年经血培养和临床资料证实的126例院内感染的复数菌败血症。结果 院内感染复数菌败血症均发生在较严重的基础疾病上．创伤性手术和操作、广谱抗菌药物和免疫抑制剂的应用、放疗与化疗为该病的危险因素。院内感染复数菌败血症感染病死率达52％，致病菌以G^-菌占多数，合并真菌感染者死亡率高。致病菌多为耐药菌株。结论 院内感染复数菌败血症病情危重，病死率高，多系耐药菌株感染。应尽早治疗原发基础疾病，避免危险因素，严格掌握侵入性诊疗手段的运用指征，合理应用抗菌药物。并重视院内环境卫生，严格做好洗手、消毒等是防止耐药菌播散的主要措施。

Clinical characteristic and resistence study of nosocomial plural pathogenic septicemia

Objective To explore the clinical characteristis and risk facters of nosocomial plural pathogenic septicemia,its pathogenic spectrum and drug resistance.Method A restrospective analysis from 1970 to 2004 was done for 126 cases of nosocomial plural pathogenic septicemia,which was confirmed by blood cultures as well as clinical presentations. Results All the 126 cases nosocomial plural pathogenic septicemia were upon different severe basicdiseases.The risk factors were:invasived opration and treatment,the use of extended-spectrum anti-microbial agents and immune depression drugs,radiotherapy and chenotherapy.The mortality of nosocomial pluralpathogenic septicemia was 52%.The major Pat hogens were Gram-negative. The mortaliy of co-infection of fungi was high.Most of the pathogens were resistance to common antibiotics.Conclusions Nosocomial plural pathogenic septicemia was critical disease with high mortality.The resistance rates to common antibiotics were high.Basic disease should be early treated and the risk factors should be avoided. Grasp the indication of intervened diagnosis and therapy strictly as well as the proper use of anti-microbial agents to avoid drug resistance.And pay attention to the environmental Sanitation of hospital,washing hands and sterilicingstrictly were the main measure to avoid the spread of drug resistant pathogens.