摘要
目的探讨成年血液病患者发生医院感染的危险因素,以降低医院感染发生率。方法对2010年1月-2012年10月5555例成年血液病患者进行病例对照研究,其中感染组712例,未感染组4843例,将因素分为患者自身因素和医源性因素,对各项指标进行分类分项,通过单因素分析筛选差异有统计学意义的变量,纳入多元lo-gistic回归分析,分析成年血液病患者发生医院感染的危险因素。结果成年血液病患者医院感染率为12.82%,例次感染率为16.47%;感染部位以呼吸系统居首占57.81%,其次为血液系统占15.41%,感染部位不明患者也占一定的比例;医院感染病原菌以革兰阴性菌为主占45.64%,真菌比例较高占25.28%;经过多元logistic回归分析,主要危险因素有造血干细胞移植、粒细胞缺乏、化疗、使用免疫抑制剂、中心静脉插管、白血病、院外感染等,ROC曲线下面积为0.821。结论成年血液病患者医院感染率高,应加强医院感染监测,针对主要危险因素采取有效地预防措施,可降低医院感染发生率。
OBJECTIVE To investigate the risk factors of nosocomial infections in adult patients with hematologic diseases so as to reduce the incidence of nosocomial infections. METHODS A case-control study was conducted for 5555 patients with hematologic diseases who were hospitalized from Jan 2010 to Oct 2012, including 712 cases in the infection group and 4843 cases in the non-infection group. The factors were classified into the patients self- factors and the iatrogenic factors, then the indicators were quantified in hierarchy, the variables with the statistical significance were screened out through the univariate analysis, finally the multivariate logistic regression analysis was carried out to analyze the risk factors of nosocomial infections in the adult patients with hematologic diseases. RESULTS The incidence of nosocomial infections in the adult patients with hematologic diseases was 12.82 %, and the case-time infection rate was 16. 47%. The respiratory tract ranked the first place of the infection sites （57.81%）, followed by the blood system （15.41%）, and the patients with unknown infection sites also took a certain proportion. The gram-negative bacteria were the main pathogens causing nosocomial infections, accounting for 45.64%, followed by the fungi （ 25. 28%）. The multivariate logistic regression analysis showed that the hematopoietic stem cell transplantation, agranulocytosis, chemotherapy, use of immunosuppressive agents, cen- tral venous catheterization, leukemia, and community-acquired infections were the main risk factors, and the area under ROC was 0. 885. CONCLUSION The incidence of nosocomial infections is high in the patients with hemato- logic diseases; it is necessary to strengthen the monitoring of nosocomial infections and take effective prevention measures according to the main risk factors so as to reduce the incidence of nosocomial infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第12期2834-2836,共3页
Chinese Journal of Nosocomiology
基金
全军医学科学技术研究"十二五"计划保健专项课题(11BJZ01)
关键词
医院感染
危险因素
血液病
Nosocomial infection
Risk factor
Hematologic disease
