慢性阻塞性肺疾病患者医院感染病原学特征与危险因素分析  

Etiological characteristics of nosocomial infections in patients with chronic obstructive pulmonary disease and analysis of risk factors

作　　者：陈丽[1] 杜永亮[1] 徐永红[1] 陈宁[1] 荣兴华 

机构地区：[1]徐州医学院第二附属医院肺科,江苏徐州221006

出　　处：《中华医院感染学杂志》2015年第10期2253-2255,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(1001420767)

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)患者医院感染病原学特征与危险因素,为临床治疗、预防提供依据。方法回顾性分析2010年5月-2014年5月医院收治的350例COPD患者临床资料,记录患者医院感染率、感染部位、病原菌分布,并分析影响医院感染的独立危险因素。结果 350例COPD患者中共有128例发生医院感染,感染率36.6%;其中轻度感染21例、中度感染84例、重度感染23例;医院感染主要部位是下呼吸道感染89例占69.5%,其次为泌尿道感染21例占16.4%;128例医院感染患者中共分离出164株病原菌,其中革兰阳性菌27株占16.5%,革兰阴性菌116株占70.7%,真菌21株占12.8%;多因素分析显示,住院时间>7d、抗菌药物使用种类>2种、留置导管是导致COPD患者医院感染的独立危险因素。结论 COPD医院感染病原菌主要是革兰阴性菌,住院时间较长、使用多种抗菌药、留置导管是导致医院感染的独立危险因素,针对危险因素进行干预,可有效控制预防医院感染的发生。OBJECTIVE To explore the etiological characteristics of nosocomial infections in the patients with chron‐ic obstructive pulmonary disease （COPD） and analyze the risk factors so as to provide guidance for clinical treat‐ment and prevention .METHODS The clinical data of 350 COPD patients who were treated in the hospital from May 2010 to May 2014 were retrospectively analyzed ,then the incidence of nosocomial infections ,infection sites ,and distribution of pathogens were recorded ,and the independent risk factors for the nosocomial infections were ob‐served .RESULTS The nosocomial infections occurred in 128 of 350 COPD patients with the infection rate of 36 .6% ,including 21 cases of mild infections ,84 cases of moderate infections ,and 23 cases of severe infections .Of the patients with nosocomial infections ,89 （69 .5% ） had the lower respiratory tract infections and 21 （16 .4% ） had the urinary tract infections .A total of 164 strains of pathogens have been isolated from the 128 patients with nosocomial infections ,including 27 （16 .5% ） strains of gram‐positive bacteria ,116 （70 .7% ） strains of gram‐neg‐ative bacteria ,and 21 （12 .8% ） strains of fungi .The multivariate analysis indicated that the length of hospital stay more than 7 days ,use of antibiotics more than 2 types ,and catheter indwelling were the independent risk factors for the nosocomial infections in the COPD patients .CONCLUSION The gram‐negative bacteria are dominant among the pathogens causing nosocomial infections in the COPD patients .The long length of hospital stay ,use of multiple antibiotics ,and catheter indwelling are the independent risk factors for the nosocomial infections .It is an effective way to take interventions aiming at the risk factors so as to control the nosocomial infections .

关 键 词：慢性阻塞性肺疾病 医院感染 病原菌 危险因素 

分 类 号：R563[医药卫生—呼吸系统]