开放性结核病患者住院期间医院感染的特点及预防对策  

Clinical characteristics and preventive measures of nosocomial infections in patients with open tuberculosis during hospitalization

作　　者：周新玲[1] 袁伟[2] 韩颖[1] 张晋[1] 张新颖[1] 王雅妹[1] ZHOU Xin-ling;YUAN Wei;HAN Ying;ZHANG Jin;ZHANG Xin-ying;WANG Ya-mei(Affiliated Hospital of Hebei University,Baoding,Hebei 071000,China)

机构地区：[1]河北大学附属医院感染控制办公室,河北保定071000 [2]河北大学附属医院结核二病区,河北保定071000

出　　处：《中华医院感染学杂志》2018年第19期2932-2935,共4页Chinese Journal of Nosocomiology

基　　金：河北省卫生计生委科研基金资助项目(2016Q013)

摘　　要：目的分析开放性结核病患者住院期间发生医院感染的临床特点及预防对策。方法回顾性分析2015年1月-2017年6月医院收治的2 386例开放性结核病患者的临床资料,对感染患者进行病原学检查,并统计患者性别、年龄、住院时间等临床资料,归纳开放性结核病患者住院期间医院感染的相关因素,并总结其预防对策。结果 2 386例患者中发生医院感染152例,感染率为6.37%,以下呼吸道感染为主。共送检感染患者178份标本,共检出126株病原菌,阳性率为70.79%。其中革兰阴性菌78株占61.90%,以肺炎克雷伯菌和铜绿假单胞菌为主;革兰阳性菌37株占29.37%,以金黄色葡萄球菌为主;真菌11株占8.73%;年龄、住院时间、侵入性操作、抗菌药物应用、糖尿病史、基础疾病史是影响医院感染发生的相关因素(P<0.05)。结论临床应检查感染相关因素和病原菌分布情况,采用针对性的预防措施,以降低医院感染率。OBJECTIVE To analyze the clinical characteristics of nosocomial infections in patients with open TB during hospitalization,and to study the feasible preventive measures.METHODS The clinical data of 2 386 patients with open tuberculosis admitted to our hospital from Jan.2015 to Jun.2017 were retrospectively analyzed.Etiological examination was performed in the infected group.The clinical data of patients including gender,age,and duration of hospitalization,were statistically analyzed.The risk factors of nosocomial infections in patients with open tuberculosis during hospitalization was summarized,and the preventive measures were summed up.RESULTS Nosocomial infections occurred in 152 of the 2386 patients,and the infection rate was 6.37%.In the 178 specimens of infected patients,126 strains of pathogens were detected,with a positive rate of 70.79%.Gram-negative bacteria were the main pathogens,accounting for 61.90%（78 strains）,dominated by Klebsiella pneumoniae and Pseudomonas aeruginosa.Gram-positive bacteria accounted for 29.37%（37 strains）,dominated by Staphylococcus aureus.Fungal pathogens accounted for 8.73%（11 strains）.Age,length of hospital stay,invasive procedures,antibiotic use,diabetes history,and history of underlying diseases were found to be risk factors of nosocomial infections（P〈0.05）.CONCLUSIONThe distribution of risk factors and pathogens should be examined in clinic,according to which corresponding preventive measures could be taken to reduce the incidence rate of nosocomial infections.

关 键 词：开放性结核病 医院感染 肺结核 相关因素 预防 

分 类 号：R825.2[医药卫生—临床医学]