神经内科住院患者医院感染病原学特点及影响因素分析  

Etiological characteristics of nosocomial infections in hospitalized patients of neurology department and influencing factors

作　　者：邓棋方[1] 罗勇[1] 李琴[1] 李静[1] 陈德林[2] 杨静[1] 朱晓燕[1] DENG Qi-fang;LUO Yong;LI Qin;LI Jing;CHEN De-lin;YANG Jing;ZHU Xiao-yan(The First People＇s Hospital of Zunyi,Zun,yi,Guizhou 563000,China)

机构地区：[1]遵义市第一人民医院神经内科,贵州遵义563000 [2]遵义市第一人民医院检验科,贵州遵义563000

出　　处：《中华医院感染学杂志》2018年第21期3222-3225,共4页Chinese Journal of Nosocomiology

摘　　要：目的分析神经内科住院患者医院感染病原学特点,探究患者发生医院感染的影响因素,为临床降低医院感染发生率制定预防措施。方法回顾性分析2013年2月份-2017年8月份医院神经内科收治的1283例住院患者的临床资料,统计患者医院感染部位、病原菌分布情况,采用单因素及多因素Logistic回归分析患者发生医院感染的影响因素。结果 1283例神经内科住院患者,发生医院感染52例,感染率为4.05%。其中呼吸道感染24例占46.15%,泌尿系统感染16例占30.77%;感染患者共分离病原菌67株,革兰阴性菌43株占64.18%,革兰阳性菌16株占23.88%,真菌8株占11.94%;年龄、合并基础疾病、住院时间、意识障碍、原发疾病、侵入性操作、基础免疫功能低下是神经内科住院患者发生医院感染的影响因素。结论影响神经内科住院患者医院感染的因素较多,应强化治疗方案的针对性,提升病房环境、强化医护无菌技术操作,尽可能降低患者住院期间医院感染的风险,提升患者治疗效果。OBJECTIVE To investigate the etiological characteristics of nosocomial infections in the hospitalized patients of neurology department and explore the influencing factors for the nosocomial infection so as to reduce the incidence of nosocomial infection and put forward the prevention measures.METHODS The clinical data of 1283 patients who were hospitalized the neurology department from Feb 2013 to Aug 2017 were retrospectively analyzed.The infection sites and species of pathogens were statistically analyzed.The univariate analysis and multivariate logistic regression analysis were performed for the influencing factors for the nosocomial infections.RESULTS Of the 1283 patients who were hospitalized the neurology department,52 had nosocomial infections,with the infection rate 4.05%,24（46.15%）of whom had respiratory tract infection,and 16（30.77%）had urinary tract infection.A total of 67 strains of pathogens were isolated from the patients with the infections,43（64.18%）of which were gram-negative bacteria,16（23.88%）were gram-positive bacteria,and 8（11.94%）were fungi.The influencing factors for the nosocomial infections in the hospitalized patients of neurology department included the age,complication with underlying diseases,length of hospital stay,disturbance of consciousness,primary diseases,invasive procedures and low immune function.CONCLUSIONS There are a variety of influencing factors for the nosocomial infections in the hospitalized patients of neurology department.It is necessary to take targeted treatment programs,improve the environment of wards and intensify the sterile operation so as to reduce the risk of nosocomial infection during the hospital stay and improve the curative effect.

关 键 词：神经内科住院患者 医院感染 影响因素 防治对策 

分 类 号：R195.4[医药卫生—卫生统计学]