慢性心力衰竭患者医院感染的临床分析  

Clinical characteristics of chronic heart failure patients complicated with nosocomial infections

作　　者：陈向东[1] 曹淑贞[1] 马军[1] 陈伟丽[1] 

机构地区：[1]金华市磐安县人民医院心血管内科,浙江金华322300

出　　处：《中华医院感染学杂志》2014年第17期4269-4271,共3页Chinese Journal of Nosocomiology

基　　金：国家"十一五"科技重大专项基金资助项目(2008ZX100-03-004);浙江省医药卫生科技计划基金项目(2013KYA220);浙江省金华市科技重点基金资助项目(2012-3-022)

摘　　要：目的探讨慢性心力衰竭住院患者发生医院感染的临床特征,以制定相应的干预对策。方法回顾性分析2008年1月-2012年12月医院577例慢性心力衰竭患者的临床资料。结果 577例慢性心力衰竭患者发生医院感染49例,感染率为8.49%;感染部位以呼吸道和泌尿道为主,分别占46.9%和28.6%;检出病原菌49株,以革兰阴性菌为主占77.5%,革兰阳性菌占18.4%,真菌占4.1%,前3位病原菌依次为铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌,分别占28.6%、22.5%、18.4%;医院感染患者相关因素分析显示,年龄大、合并其他基础疾病、心功能不全和射血分数低、使用抑酸药物、低蛋白血症、预防应用抗菌药物、住院时间长、侵入性操作是医院感染的危险因素(P<0.05)。结论慢性心力衰竭患者医院感染的发生由多种因素导致,要针对患者医院感染的特点,采取针对性的预防措施和对策,有效地控制和降低医院感染的发生。OBJECTIVE To explore the clinical characteristics of the chronic heart failure patients complicated with nosocomial infections so as to put forward corresponding intervention countermeasures. METHODS The clinical data of 577 patients with chronic heart failure who were treated in the hospital were retrospectively analyzed. RESULTS Of the 577 patients with chronic heart failure, the nosocomial infections occurred in 49 cases with the infection rate of 8.49% among the 49 patients, 46.9% were with the respiratory tract infections, 28.6% with the urinary tract infections. A total of 49 strains of pathogens have been isolated, among which the gram-negative bacteria accounted for 77.5%, the gram-positive bacteria 18.4%, the fungi 4.1% the Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae ranked the top three species of pathogens, accounting for 28.6%, 22.5 %, and 18.4%, respectively. The analysis of the related factors for nosocomial infections showed that the old age, complication of other underlying diseases, cardiac dysfunction, low ejection fraction, use of acid-suppressing agent, hypoalbuminemia, prophylactic use of antibiotics, long length of hospital stay, and invasive operation were the risk factors for the nosocomial infections. CONCLUSION There are a variety of risk factors for nosocomial infections in the patients with chronic heart failure. It is necessary to take targeted prevention countermeasures according to the characteristics of the patients with nosocomial infections so as to effectively control the nosocomial infections.

关 键 词：慢性心力衰竭 医院感染 临床特征 

分 类 号：R181.32[医药卫生—流行病学]