老年呼吸科住院患者发生医院感染的病原学特点及危险因素分析  

Pathogenic characteristics and risk factors of nosocomial infection in geriatric respiratory inpatients

作　　者：郑明旭[1] 王淑云[1] 蒋云书 张晓健 ZHENG Mingxu;WANG Shuyun;JIANG Yunshu;ZHANG Xiaojian(The second people′s Hospital of Liaocheng City,Liaocheng,Shandong 252600,China;People′s Hospital of Taian City,Taian,Shandong 271000,China)

机构地区：[1]聊城市第二人民医院,山东聊城252600 [2]山东泰安市人民医院,山东泰安271000

出　　处：《国际检验医学杂志》2019年第23期2864-2867,共4页International Journal of Laboratory Medicine

基　　金：泰安市科技发展计划项目（2017NS0159）

摘　　要：目的探讨老年呼吸科住院患者发生医院感染的病原学特点及危险因素,为医院预防感染提供参考依据。方法选取2016年1月至2018年1月该院呼吸科收治的1589例住院老年患者作为研究对象,回顾性分析其中112例发生医院感染的老年患者临床资料,观察患者感染病原学特点,对相关影响因素进行单因素、logistic多因素分析,探讨影响医院感染的危险因素,并提出预防措施。结果患者感染部位主要在呼吸道,上呼吸道74例,占比66.07%,下呼吸道25例,占比22.32%,泌尿道7例,占比6.25%,其他部位占比较少;感染病原菌共检出115株,主要是革兰阴性菌,检出86株,占比74.78%,其中最多的是鲍曼不动杆菌,其次是真菌,检出24株,占比20.87%,其中最多的是白色念珠菌,革兰阳性菌检出5株,占比4.35%,其中最多的是金黄色葡萄球菌;经单因素分析显示,年龄、住院天数、肺部感染、抗菌药物使用、留置导尿管与医院感染有关(P<0.05),性别、吸烟史、糖尿病史与医院感染无关(P>0.05);经logistic多因素分析显示,年龄≥60岁、住院天数≥2周、有肺部感染、使用抗菌药物、留置导尿管是医院感染的危险因素,会增加医院感染发生率(P<0.05)。结论老年呼吸科住院患者医院感染以呼吸道为主,感染病原菌以革兰阴性菌为主,感染的概率较高,危险因素较多,临床诊治应根据相关危险因素,采取对症治疗措施,控制、减少医院感染发生。Objective To explore the etiological characteristics and risk factors of nosocomial infection in elderly respiratory inpatients,and to provide reference for nosocomial infection prevention.Methods 1589 elderly hospitalized patients in respiratory department of our hospital from January 2016 to January 2018 were selected as the research objects.Clinical data of 112 elderly patients with nosocomial infection were retrospectively analyzed.Pathogenic characteristics of nosocomial infection were observed.Single-factor and Logistic multifactor analysis were carried out to investigate the risk factors of nosocomial infection,and preventive measures were put forward.Results The main infection sites were respiratory tract,upper respiratory tract,74 cases(66.07%),lower respiratory tract,25 cases(22.32%),urinary tract,7 cases(6.25%)and other parts(less);115 strains of pathogenic bacteria were detected,mainly Gram-negative bacteria,86 strains(74.78%).Among them,Acinetobacter baumannii,followed by fungi,24 strains(20.87%)were detected.Among them,5 strains were Candida albicans and 5 strains were Gram-positive bacteria,accounting for 4.35%.The most strains were Staphylococcus aureus.Univariate analysis showed that age,hospitalization days,pulmonary infection,use of antibiotics and indwelling catheter were related to nosocomial infection(P<0.05),while sex,smoking history and diabetes history were not related to nosocomial infection(P>0.05).Factor analysis showed that age(≥60),hospitalization days(≥2 weeks),pulmonary infection,use of antibiotics and indwelling catheter were risk factors of nosocomial infection,which increased the incidence of nosocomial infection(P<0.05).Conclusion Respiratory tract is the main nosocomial infection in geriatric respiratory patients.Gram-negative bacteria are the main pathogens of nosocomial infection.The incidence of nosocomial infection is higher and there are many risk factors.Clinical diagnosis and treatment should take symptomatic treatment measures according to the relevant risk factors

关 键 词：呼吸科 医院感染 病原学特点 危险因素 预防 

分 类 号：R446.5[医药卫生—诊断学]