老年恶性肿瘤患者院内感染和多重耐药菌感染的危险因素研究  

Risk factors of nosocomial infection and multidrug-resistant organisms infection in elderly patients with malignant tumor

作　　者：孙玉玲[1] 马颖欣 鲍中英[1] 郭阳[1] 薛文英 SUN Yu-ling;MA Ying-xin;BAO Zhong-ying;GUO Yang;XUE Wen-ying(Department of Infection,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;不详)

机构地区：[1]首都医科大学附属北京世纪坛医院感染科,北京100038 [2]首都医科大学附属北京世纪坛医院干部保健办公室,北京100038

出　　处：《现代预防医学》2021年第16期3048-3054,共7页Modern Preventive Medicine

基　　金：北京市保健课题项目(京19-1号)。

摘　　要：目的探讨老年恶性肿瘤患者发生院内感染和多重耐药菌(multiple drug resistant organisms,MDRO)感染的危险因素,为制订有效的院内感染预防控制措施提供科学依据。方法回顾性分析2015年1月-2019年12月我院收治的60岁以上恶性肿瘤患者的病历资料,应用多因素logistic回归分析老年恶性肿瘤患者发生院内感染和MDRO感染的危险因素。结果老年恶性肿瘤患者院内感染发生率为25.27%,MDRO感染率为31.69%。logistic回归分析显示,中至重度衰弱、合并糖尿病、侵入性操作和长期卧床是老年恶性肿瘤患者发生院内感染[OR(95%CI):3.26(1.22~5.47)、1.77(1.20~2.53)、1.96(1.28~3.48)和2.14(1.67~3.89)]和发生MDRO感染的危险因素[OR(95%CI):2.35(1.13~5.67)、1.84(1.15~4.62)、2.38(1.41~5.52)和1.21(1.35~3.89)];合并慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)、住院时间≥14 d和低白蛋白水平仅是院内感染的危险因素[OR(95%CI):2.01(1.22~4.08)、2.23(1.41~4.33)和1.21(1.05~2.77)];ICU入住时间≥1周、应用抗菌药物≥3种和抗菌药物应用时间≥14 d仅是MDRO感染的危险因素[OR(95%CI):2.55(1.50~5.63)、1.91(1.23~4.15)和2.11(1.32~4.28)]。结论老年恶性肿瘤患者院内感染率和MDRO感染率均较高,并且危险因素较多,应针对这些危险因素采取科学有效的预防控制措施,以降低院内感染和MDRO感染的发生率。Objective To explore the risk factors of nosocomial infection and multidrug-resistant organisms(MDRO)infection in elderly patients with malignant tumor,so as to provide scientific basis for formulating effective prevention and control measures of nosocomial infection.Methods We retrospectively analyzed the medical records of patients over 60 years old with malignant tumor in our hospital from January 2015 to December 2019.The risk factors of nosocomial infection and MDRO infection in elderly patients with malignant tumor were analyzed by multivariate logistic regression analysis.Results The incidence of nosocomial infection was 2.27%and that of MDRO was 31.69%.Logistic regression analysis showed that moderate to severe frailty,diabetes mellitus,invasive operation and long-term bedridden were the risk factors for nosocomial infection[OR(95%CI):3.26(1.22-5.47),1.77(1.20-2.53),1.96(1.28-3.48)and 2.14(1.67-3.89)]and MDRO infection[OR(95%CI):2.35(1.13-5.67),1.84(1.15-4.62),2.38(1.41-5.52)and 1.21(1.35-3.89)].Combining with chronic obstructive pulmonary disease(COPD),hospital stays≥14 days and low albumin level were only risk factors for nosocomial infection[OR(95%CI):2.01(1.22-4.08),2.23(1.41-4.33)and 1.21(1.05-2.77)];ICU stay≥1 week,more than 3 antibiotics use and longer duration of antibiotics use≥14 days were only risk factors for MDRO infection[OR(95%CI):2.55(1.50-5.63),1.91(1.23-4.15)and 2.11(1.32-4.28)].Conclusion The nosocomial infection rate and MDRO infection rate of elderly patients with malignant tumor are higher,and there are many risk factors.Scientific and effective prevention and control measures should be taken to reduce the incidence of nosocomial infection and MDRO infection.

关 键 词：恶性肿瘤 老年人 医院感染 多重耐药菌 

分 类 号：R730[医药卫生—肿瘤]