摘要
目的 了解严重急性呼吸综合征 (SARS)患者医院感染状况及影响因素。方法 对 2 0 0 3年 2～ 6月 ,我院收治的 87例 SARS患者医院感染进行回顾性调查。结果 医院感染率 2 4 .14 % ,重型 4 2 .2 8% ;高发时间段是在住院的平均 (7.5± 8.4 ) d;医院感染部位分布以口腔感染多见 ,占 4 3.84 % ,其次为肠道占 36 .99%、上呼吸道占10 .96 %、下呼吸道占 5 .4 8%、胸腔和泌尿道各占 1.37% ;病原菌中真菌为 85 .71% ,G- 菌为 10 .71% ,G+ 菌为3.5 7% ;医院感染的高危因素以重型和老年为主 (OR值 2 0 .2 7和 OR值 30 .5 ) ,其次为呼吸机使用 (OR值15 .2 9)、CD4 + / CD8+ ↓ (OR值 13.2 )、侵袭性操作 (OR值 10 .5 )、糖皮质激素使用 (OR值 7.313)、反复吸痰 (OR值 2 .4 5 6 )。结论 SARS患者医院感染率高 ,与多因素有关 ,尤其需严格掌握无创和有创呼吸机使用、激素使用的适应证、时机和剂量。
OBJECTIVE To study the status of nosocomial infection and risk factors in patients with severe acute respiratory syndrome (SARS). METHODS From Feb to Jun 2003,87 inpatients with SARS were retrospectively analyzed. RESULTS The total infection rate was 24.14%. From them 42.28% of the patients were heavy type and most inpatients were found the symptoms in (7.5±8.4) days. The common sites of nosocomial infection were mouth (43.84%),intestinal tract (36.99%),upper respiratory tract (10.96%),lower respiratory tract (5.48%),thorax (1.37%) and urinary tract (1.37%). The pathogens included fungi (85.71%),Gram-negative bacteria (10.71%),and Gram-positive ones (3.57%). The predominant risk factors were heavy type and the old elderly (OR 20.27 and 30.5 ),use of ventilator (OR 15.29),CD 4 +/CD 8 +↓(OR 13.2),invasive operation (OR 10.5),use of corticosteroids (OR 7.313),and sputum extraction (OR 2.456). CONCLUSIONS The higher nosocomial infection rate in patients with SARS was related with more factors. The preventive measures should control the use of ventilator and the time and dose of corticosteroid used.
出处
《中华医院感染学杂志》
CAS
CSCD
2004年第5期535-537,共3页
Chinese Journal of Nosocomiology
关键词
SARS
医院感染
相关因素
SARS
Nosocomial infection
Correlation factor
