精神科住院患者医院感染危险因素调查  

Risk factors for nosocomial infections in hospitalized patients of psychiatrics department

作　　者：程德君[1] 张桂艳[2] 冯砚国[1] 王娟[1] 孙臻[1] 

机构地区：[1]河南省精神病院.新乡医学院第二附属医院精神一科,河南新乡453002 [2]河南省精神病院.新乡医学院第二附属医院功能检查科,河南新乡453002

出　　处：《中华医院感染学杂志》2016年第6期1374-1376,共3页Chinese Journal of Nosocomiology

基　　金：河南科技厅基金资助项目(XP201501114)

摘　　要：目的调查引起精神科住院患者医院感染危险因素,为有效预防及降低医院感染的发生提供科学参考。方法对2014年1月-2015年6月住院治疗的534例精神科住院患者临床资料进行回顾性调查,数据采用SPSS19.0软件进行统计分析,多因素分析采用非条件多因素logistic回归分析。结果 534例患者医院感染55例,感染率10.30%;感染部位以呼吸道为主占58.18%,共培养出病原菌48株,主要为肺炎克雷伯菌、大肠埃希菌、金黄色葡萄球菌,分别占43.75%、22.91%、6.67%;单因素分析年龄>60岁、患精神分裂症、住院≥2次、抗精神病药物使用≥2种、合并其他疾病、抗菌药物使用、有保护性约束、PANSS症状评分高、抗精神病药物不良反应评分高等是引起患者医院感染的危险因素(P<0.05);非条件多因素logistic回归分析,所患疾病为精神分裂症、住院≥2次、抗精神病药物使用≥2种、合并糖尿病、抗菌药物使用≥2种、有保护性约束、PANSS症状评分高、抗精神病药物不良反应评分是引起患者医院感染的独立危险因素(P<0.05)。结论引起精神科住院患者发生医院感染的危险因素较多,应采取措施进行干预。OBJECTIVE To investigate the risk factors for nosocomial infections in hospitalized patients of psychiatrics department so as to provide scientific basis for effective prevention of the nosocomial infections.METHODS The clinical data of 534 patients who were hospitalized the department of psychiatrics from Jan 2014 to Jun 2015 were retrospectively investigated,the statistical analysis of data was performed by using SPSS19.0software,and the no-conditional multivariate logistic regression analysis was carried out.RESULTS The nosocomial infections occurred in 55 of 534patients,with the infection rate 10.30%;the patients with respiratory tract infections were dominant,accounting for 58.18%.A total of 48 strains of pathogens were isolated,of which 43.75% were Klebsiella pneumoniae,22.91% were Escherichia coli,and 16.67% were Staphylococcus aureus.The univariate analysis showed that the risk factors for the nosocomial infections included the more than 60 years of age,schizophrenia,no less than 2times of hospitalization,complications with other diseases,use of antibiotics,protective constraint,high PANSS score,and high score of antipsychotic drug-induced adverse reactions（P0.05）.The nonconditional multivariate logistic regression analysis indicated that the independent risk factors for the nosocomial infections included the schizophrenia,no less than 2times of hospitalization,use of no less than 2types of antipsychotic drugs,complications of diabetic mellitus,use of no less than 2types of antibiotics,protective constraint,high PANSS score,and score of antipsychotic drug-induced adverse reactions（P0.05）.CONCLUSION There are a variety of risk factors for the nosocomial infections in the hospitalized patients of psychiatrics department,and it is necessary to take the intervention measures.

关 键 词：精神科 住院患者 医院感染 高危因素 

分 类 号：R749[医药卫生—神经病学与精神病学]