ICU患者导管相关性感染危险因素logistic回归分析与预防措施  

Logistic regression analysis of risk factors and preventive measures of catheter-related infections in ICU patients

作　　者：卢艳霞[1] 尹洪花[2] 刘新平[1] 张海军 芦艳青 

机构地区：[1]滨州市人民医院重症监护室,山东滨州256610 [2]滨州市人民医院产科,山东滨州256610 [3]滨州市滨城区人民医院外科,山东滨州256651 [4]滨州市滨城区人民医院儿科,山东滨州256651

出　　处：《中华医院感染学杂志》2016年第5期1047-1049,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(ZR2009CL018)

摘　　要：目的探讨重症监护病房(ICU)住院患者发生导管相关性感染的病原菌分布与危险因素分析,为降低ICU导管相关性感染率提供依据。方法回顾性分析2012年9月-2015年8月医院入住ICU的2 000例患者,分析ICU住院患者导管相关性感染病原菌分布特点及相关危险因素,采用SPSS 16.0软件进行统计分析。结果 2 000例ICU患者发生导管相关性感染73例,发生率为3.65%,共检出病原菌116株,检出革兰阴性菌、革兰阳性菌、真菌分别占57.76%、37.07%、5.17%;单因素分析显示,ICU患者年龄≥65岁、APACHEⅡ评分≥17分、ICU住院时间≥14d、血清白蛋白含量<30g/L、留置时间≥1周等是发生导管相关性感染的危险因素(P<0.05);经logistic回归分析发现,年龄≥65岁、APACHEⅡ评分≥17分、ICU住院时间≥14d、血清白蛋白含量<30g/L、留置时间≥1周是ICU患者发生导管相关性感染的独立危险因素(P<0.05)。结论 ICU住院患者导管相关性感染病原菌主要为革兰阴性菌,感染相关危险因素较多,应采取相应预防措施。OBJECTIVE To investigate the pathogen distribution and risk factors of catheter-related infections in ICU patients,so as to provide basis for reducing the ICU catheter-related infections.METHODS Totally 2000 ICU patients from Sep.2012 to Aug.2015 in the hospital were collected,and their clinical data were retrospectively analyzed.Pathogens distribution and related risk factors of catheter-related infections in ICU patients were analyzed.The results were statistically analyzed by SPSS 16.0software.RESULTS A total of 73 patients got catheterrelated infections among 2000 ICU patients,and the incidence was 3.65%.A total of 116 strains of pathogens were detected,including gram-negative bacteria,gram-positive bacteria,and fungi,each with 57.76%,37.07%,and 5.17%.Gram-negative bacteria were mainly Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli.Gram-positive bacteria mainly included Staphylococcus aureus,and Streptococcus pneumoniae.Univariate analysis showed that age ≥65years,APACHEⅡ Rating ≥17 points,ICU length of stay ≥14d,albumin〈30g/L,retention time≥1week,indwelling catheters 〉one kind,the joint use of antimicrobial drugs 〉two kinds,complete parenteral nutrition,chronic underlying disease were risk factors for catheter-related infections in ICU patients（P〈0.05）;logisticregression analysis showed that age≥65years,APACHEⅡscore≥17points,ICU length of stay≥14d,albumin〈30g/L,retention time≥1week were independent risk factors for ICU patients with catheter-related infections（P〈0.05）.CONCLUSION The results showed that the pathogens causing catheter-related infections were mainly gram-negative pathogens and related risk factors were various in ICU patients.Appropriate preventive measures should be taken correspondingly.

关 键 词：重症监护病房 导管相关性感染 病原菌 危险因素 

分 类 号：R515.3[医药卫生—内科学]