摘要
目的探讨肾内科住院患者发生医院感染的临床特点和相关危险因素,以采取有效措施降低其发生率。方法对1620例肾内科住院患者的临床资料进行分析,研究其医院感染发生的临床特点和相关危险因素。结果肾内科患者医院感染91例,感染率为5.62%;医院感染发生的常见部位是呼吸道52例,占57.14%,其次为泌尿道、皮肤、胃肠道、其他,分别占17.58%、13.19%、8.79%、3.30%;感染病原菌以革兰阴性菌为多见占89.01%,革兰阳性菌占5.49%,真菌占3.30%,其他占2.20%;单因素分析显示,肾内科医院感染与年龄(≥60岁)、住院时间(≥3周)、侵入性操作、抗菌药物使用种类、血清白蛋白(<30g/L)、合并基础疾病、使用糖皮质激素等因素有相关性(P<0.05);logistic因素回归分析发现,年龄(OR=2.118,P=0.014)、合并基础疾病(OR=2.227,P=0.007)、抗菌药物种类(OR=2.713,P=0.009)和侵入性操作(OR=2.754,P=0.012)是医院感染发生的独立危险因素。结论影响肾内科医院感染发生的因素多种多样,应减少侵入性操作与严格无菌技术操作,合理应用抗菌药物,改善营养状况,积极控制基础疾病,严格掌握糖皮质激素使用指征,降低医院感染的发生。
OBJECTIVE To explore the characteristics and risk factors of the nosocomial infections in the patients of nephrology department so as to take effective measures to reduce the incidence rate. METHODS The characteristics and risk factors of nosocomial infection in 1620 patients of nephrology department were retrospectively analyzed. RESULTS Of the patients in the nephrology department, the nosocomial infections occurred in 91 patients with the incidence rate of 5.62 %. The respiratory tract was the most common infection site （52 cases, 57.14 % ）, followed by the urinary tract （17.58%）, the skin （13.19%）, the gastrointestinal tract （8.79%）, and others （3.30%）. The gram-negative bacteria were the predominant pathogens （89.01%）, followed by the gram-positive bacteria, fungi （3.30 % ）, and others （2.200%）. The univariate analysis indicated that the incidence of infections was related to the age （more than 60 years）, hospitalization duration （more than 3 weeks ）, invasive manipulation, types of antibiotics sued, level of blood albumin （less than 30g/L）, complication of primary diseases, and usage of glucocorticoids（P〈0.05） , while the Logistic regression analysis showed that the age（OR = 2. 118, P = 0. 014）, complication of primary diseases （OR= 2. 227 ,P=0. 007）, types of antibiotics used （OR= 2. 713, P= 0. 009）, and invasive manipulation（OR = 2. 754, P = 0. 012） were the independent risk factors of the nosocomical infections. CONCLUSION There are a variety of factors associated with the nosocomial infections in the nephrology depart- ment, it is necessary to reduce the invasive operation, strictly implement aseptic operation, reasonably use antibi- otics , improve the nutrition status, actively control the underlying diseases, and grasp the indications for use of glucocorticoids so as to reduce the incidence of the nosocomial infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第7期1553-1555,共3页
Chinese Journal of Nosocomiology
关键词
.肾内科
医院感染
危险因素
Nephrology department
Nosocomial infection
Risk factor
