老年人医院获得性尿路感染的危险因素分析  

Risk factors for hospital-acquired urinary tract infection in the elderly

作　　者：胡娟娟 陈庆丽 HU Juan-juan;CHEN Qing-li(Department of Urology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学第一附属医院泌尿外科,江苏省南京市210008

出　　处：《实用老年医学》2020年第3期287-290,共4页Practical Geriatrics

摘　　要：目的探讨老年人医院获得性尿路感染(hospital-acquired tract infection,HAUTI)的危险因素。方法选取我院2017~2018年间年龄>60岁的215例HAUTI病人作为病例组,另选取同性别、同科室、年龄匹配且无HAUTI的病人215例作为对照组。查阅2组病人的相关病历资料,统计并比较2组病人的侵入性操作、合并症及临床用药情况;采用多因素Logistic回归分析HAUTI的危险因素。结果老年HAUTI病人中,基础疾病为神经系统疾病的病人占53.9%;病原菌分布以革兰阴性菌(55.8%)为主,前三位病原菌分别是大肠埃希菌、屎肠球菌和肺炎克雷伯杆菌。多因素Logistic分析结果显示,留置尿管(OR=3.153,95%CI:1.033~7.661)、气管插管(OR=1.972,95%CI:1.081~3.772)、中心静脉置管(OR=1.231,95%CI:1.008~5.332)、DM(OR=1.985,95%CI:1.781~4.772)、使用糖皮质激素(OR=1.723,95%CI:1.086~3.763)是HAUTI的独立危险因素。结论老年HAUTI病人中,基础疾病为神经系统疾病的病人为其主要易感人群,病原菌分布以革兰阴性肠杆菌为主。留置尿管、气管插管、中心静脉置管、DM、使用糖皮质激素是HAUTI的独立危险因素。Objective To investigate the risk factors of hospital-acquired urinary tract infection(HAUTI)in the elderly.Methods 215 cases of patients with HAUTI aged over 60 years in our hospital from January 2017 to December 2018 were selected as the case group,another 215 cases of patients without HAUTI who matched in age,gender and department were selected as the control group.The related medical records of the patients in the two groups were collected.The condition of invasive operation,complications and clinical medication were compared between the two groups,and the risk factors of HAUTI were analyzed by multi-factor Logistic regression.Results Among the elderly patients with HAUTI,patients with neurological diseases(53.9%)were the main susceptible population;the main pathogen was gram-negative bacteria(55.8%),and the top 3 pathogens were Escherichia coli,Enterococcus faecium and Klebsiellapneumonia respectively.Multivariate Logistic analysis showed that indwelling catheter(OR=3.153,95%CI:1.033-7.661),trachealcannula(OR=1.972,95%CI:1.081-3.772),central venous catheterization(OR=1.231,95%CI:1.008-5.332),diabetes(OR=1.985,95%CI:1.781-4.772)and use of glucocorticoids(OR=1.723,95%CI:1.086-3.763)were the independent risk factors for HAUTI.Conclusions Among the elderly patients with HAUTI,the patients whose basic diseases are nervous system diseases are the main susceptible population,and the main pathogens are gram-negative enterobacter.Indwelling catheter,trachealcannula,central venous catheterization,diabetes and use of glucocorticoids are the independent risk factors for HAUTI.

关 键 词：医院获得性尿路感染 危险因素 老年人 

分 类 号：R691.3[医药卫生—泌尿科学]