心内科住院患者医院感染的临床特点分析  

Clinical characteristics and countermeasures of nosocomial infections in patients of cardiology department

作　　者：胡华龙[1] 张卫[1] 

机构地区：[1]湖北省通城县人民医院内科,湖北通城县437400

出　　处：《中华医院感染学杂志》2013年第3期535-537,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析心内科住院患者发生医院感染的临床特点,为临床制定控制医院感染措施提供依据。方法收集心内科住院治疗的患者1509例,观察其医院感染的发生率、病原菌的分布,分析发生医院感染的高危因素。结果 98例患者发生医院感染,感染率6.49%,其中肺部感染77例,占78.57%,检出革兰阴性菌最高70株占71.43%,肺炎克雷伯菌及金黄色葡萄球菌分别占23.47%和20.41%;单因素分析:年龄>60岁、住院时间≥30d、白蛋白≤30g/L、合并糖尿病、左室射血分数(LVEF)≤40.00%及美国纽约心脏病学会(NYHA)心功能分级≥Ⅲ级是心内科住院患者发生医院感染的高危因素;多因素分析:住院时间≥30d、合并糖尿病、LVEF≤40.00%、心功能分级≥Ⅲ级是心内科住院患者发生医院感染重要的危险因素。结论多种危险因素可以导致心内科住院患者发生医院感染,应该采取积极有效的预防措施,防患于未然。OBJECTIVE To analyze the clinical features and countermeasure of the nosocomial infections in the hospitalized patients of cardiology department so as to provide basis for the clinical preuention of nosocomial infections.METHODS A total of 1509 patients in cardiology department were chosen,the incidence of nosocomial infection,pathogen distribution and risk factors for nosocomial infection were observed and analyzed.RESULTS There were 98 nosocomial infection cases with the infection rate of 6.49%,among which there were 77（78.57%） cases with pulmonary infections.Totally 70（71.43%） strains of gram-negative bacteria were isolated,among which the Klebsiella pneumoniae and Staphylococcus aureus strains accounted for 23.47% and 20.41%,respectively.Univariate analysis showed that more than 60 years of age,hospitalization duration more than 30 days,albumin level higher than 30g / L,diabetes mellitus,LVEF more than 40.00% and cardiac function higher than Ⅲ class（NYHA） were risk factors of nosocomial infections in the department of cardiology.Multiple logistic analysis showed that length of hospital stay more than 30 days,diabetes,LVEF more than 40.00%,and the cardiac functional class higher than Ⅲ class（NYHA） were the risk factors of nosocomial infections in the department of cardiology.CONCLUSION There are multiple risk factors that can lead to the nosocomial infections in the department of cardiology,it is necessary to take effective prevention measures so as to prevent the nosocomial infections.

关 键 词：心内科 医院感染 危险因素 病原菌 

分 类 号：R181.32[医药卫生—流行病学]