Jian Zhang, Pediatric Intensive Care Unit, The First Affiliated Hospital of Xinxiang Medical University Weihui 453100, P. R. China.
Yan Yuan, Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University Weihui 453100, P. R. China.
Pak J Med Sci. 2014 May;30(3):554-7. doi: 10.12669/pjms.303.4648.
To study the pathogen distribution, antimicrobial susceptibility and risk factors of postoperative nosocomial infections among children with congenital heart disease.
Three hundreds children with congenital heart disease admitted to our hospital to receive surgeries from February 2010 to February 2013 were selected.
A total of 120 children were tested as positive by sputum culture, with the infection rate of 40.0%. The top five most common pathogenic microorganisms included Staphylococcus epidermidis, Staphylococcus aureus, Enterococcus, Pseudomonas aeruginosa, and Candida albicans. S. epidermidis, S. aureus and Enterococcus were highly resistant to penicillin, azithromycin and erythromycin, moderately susceptible to levofloxacin and cefazolin, and completely susceptible to vancomycin. Multivariate Logistic regression analysis showed that hospitalization stay length, combined use of antibiotics, systemic use of hormones, mechanical ventilation and catheter indwelling were the independent risk factors of postoperative nosocomial infections (P<0.05).
Nosocomial infection, which was the most frequent postoperative complication of pediatric congenital heart disease, was predominantly induced by Gram-positive bacteria that were highly susceptible to cephalosporins and vancomycin. Particular attention should be paid to decrease relevant risk factors to improve the prognosis.
研究先天性心脏病患儿术后医院感染的病原菌分布、药敏情况及危险因素。
选取我院 2010 年 2 月至 2013 年 2 月收治的 300 例行手术治疗的先天性心脏病患儿。
共 120 例患儿经痰培养检测为阳性，感染率为 40.0%。前 5 位主要的病原菌包括表皮葡萄球菌、金黄色葡萄球菌、肠球菌、铜绿假单胞菌和白色假丝酵母菌。表皮葡萄球菌、金黄色葡萄球菌和肠球菌对青霉素、阿奇霉素和红霉素高度耐药，对左氧氟沙星和头孢唑林中度敏感，对万古霉素完全敏感。多因素 Logistic 回归分析显示，住院时间长、联合使用抗生素、全身使用激素、机械通气和留置导管是术后医院感染的独立危险因素（P<0.05）。
医院感染是小儿先天性心脏病术后最常见的并发症，主要由革兰阳性菌引起，对头孢菌素类和万古霉素高度敏感。应特别注意降低相关危险因素，以改善预后。
