高危孕产妇医院感染与影响因素分析  

Influencing factors for nosocomial infections in high-risk pregnant women

作　　者：肖枝兰 蔡文波 段秀方 熊兰姣 胡小玲[1] 

机构地区：[1]湖北省汉川市人民医院(武汉大学人民医院汉川医院)妇产科,湖北汉川431600 [2]湖北省云梦县人民医院妇产科,湖北云梦432500 [3]湖北省汉川市妇幼保健院妇产科,湖北汉川431600

出　　处：《中华医院感染学杂志》2017年第6期1384-1386,1390,共4页Chinese Journal of Nosocomiology

基　　金：湖北省科学技术厅基金资助项目(EK2013D200016000155)

摘　　要：目的分析高危孕产妇医院感染情况及相关影响因素,为临床诊疗提供依据。方法选择医院妇产科2014年1月-2015年12月孕产妇1000例为研究对象,高危孕产妇586例为高危组,正常孕产妇414例为对照组,收集所有孕产妇的临床资料。结果高危组医院感染率高于对照组(P<0.05);23例高危孕产妇医院感染患者中,呼吸道感染11例,占47.8%,生殖道感染7例,占30.4%,切口感染4例,占17.4%,泌尿系感染1例,占4.3%;23例高危孕产妇医院感染患者中检出病原菌20株,其中革兰阳性菌11株,占55.0%,革兰阴性菌8株,占40.0%,真菌1株,占5.0%;正规产检者、城镇户籍者、无侵入性操作者、住院时间<7d者、阴道分娩者的医院感染率低于未正规产检者、农村户籍者、侵入性操作者、住院时间≥7d者、非阴道分娩者(P<0.05);侵入性操作、分娩方式是高危孕产妇医院感染的独立相关因素(P<0.05)。结论高危孕产妇的医院感染率较高,主要为金黄色葡萄球菌和大肠埃希菌感染,侵入性操作、分娩方式是高危孕产妇医院感染的独立影响因素。OBJECTIVE To investigate the prevalence of nosocomial infections in high-risk pregnant women and analyze the related influencing factors so as to provide guidance for clinical diagnosis and treatment.METHODS A total of 1000 pregnant women who were treated in department of gynecology and obstetrics from Jan 2014 to Dec 2015 were recruited as the study objects;586high-risk pregnant women were assigned as the high-risk group,and 414 normal pregnant women were set as the control group.The clinical data of all the pregnant women were collected.RESULTS The incidence rate of nosocomial infections was higher in the high-risk group than in the control group（P〈0.05）.Of 23high-risk pregnant women with the nosocomial infections,11（47.8%）had respiratory tract infection,7（30.4%）had genital tract infection,4（17.4%）had incision infection,and 1（4.3%）had urinary tract infection.Totally 20 strains of pathogens were isolated from the 23high-risk pregnant women with nosocomial infections,including 11（55.0%）strains of gram-positive bacteria,8（40.0%）strains of gram-negative bacteria,and 1（5.0%）strain of fungus.The incidence rate of nosocomial infections was lower in the pregnant women who received standard prenatal examination,had urban residential registration,did not receive invasive operations,stayed in hospital for less than 7days,or underwent the vaginal delivery than in the pregnant women who did not receive standard prenatal examination,had rural residential registration,receive invasive operations,stayed in hospital for no less than 7days,or did not receive the vaginal delivery（P〈0.05）.The invasive operation and delivery modes were the related independent factors for the nosocomial infections in the high-risk pregnant women.CONCLUSION The prevalence rate of nosocomial infections is high in the high-risk pregnant women;Staphylococcus aureus and Escherichia coli are dominant among the pathogens causing the nosocomial infections.The invasive operation and delivery mode are the independent in

关 键 词：医院感染 高危孕产妇 病原菌 危险因素 

分 类 号：R714[医药卫生—妇产科学]