老年住院患者发生导尿管相关尿路感染的危险因素及临床特点研究  

The risk factors and clinical characteristics of urinary tract infections related to catheterization in elderly hospitalized patients

作　　者：沈丽 冀婵娟 常欣 孙文雯 赵清 张锦 Shen Li;Ji Chanjuan;Chang Xin;Sun Wenwen;Zhao Qing;Zhang Jin(Department of Disease Prevention and Control,the First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China;Department of Internal Medicine,PLA Unit 63750 Hospital,Xi'an 710032,China;Department of Nursing,PLA Unit 63750 Hospital,Xi'an 710032,China;Department of Outpatient,the First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学第一附属医院疾病预防控制科,西安710032 [2]解放军63750部队医院内二科,西安710032 [3]解放军63750部队医院护理部,西安710032 [4]空军军医大学第一附属医院门诊部,西安710032

出　　处：《国际泌尿系统杂志》2025年第1期91-95,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨老年住院患者发生导尿管相关尿路感染(CAUTI)的危险因素及临床特点。方法选取2020年1月1日至2022年12月31日在西京医院住院期间留置导尿管的5595例患者作为研究对象,根据住院期间是否发生过CAUTI将患者分为CAUTI组(115例)和无CAUTI组(5480例),分析老年住院患者发生CAUTI的危险因素及临床特点。结果使用导尿管40552导管日,例次感染率为2.06%,千导管日感染率为2.84‰。单因素分析结果显示,住院时间、留置尿管时间、尿液pH值等均与发生CAUTI具有相关性(均P<0.001)。多因素logistic回归分析结果显示,尿液pH值≥6.5、自理能力分级为中、重度依赖、女性、住院时间≥14 d、留置尿管时间≥10 d、糖尿病、营养不良均是老年住院患者发生CAUTI的独立危险因素(均P<0.05)。CAUTI组患者的发热、降钙素原异常、尿亚硝酸盐阳性、检出多重耐药菌(MDRO)、排尿功能异常、平车入院比例均高于无CAUTI组,差异均有统计学意义(均P<0.001)。结论尿液pH≥6.5、自理能力为中、重度依赖及营养不良是老年住院患者发生CAUTI的危险因素,可作为新的防控思路应用于临床。该研究通过大样本量分析出老年CAUTI临床特点,为其诊断提供了可靠依据,对老年CAUTI防控具有重要意义。Objective To investigate the risk factors and clinical characteristics of catheter-associated urinary tract infection(CAUTI)among elderly hospitalized patients.Methods A total of 5595 patients who underwent indwelling urinary catheterization during hospitalization in Xijing Hospital from January 1,2020,to December 31,2022 were enrolled as study subjects.Patients were divided into the CAUTI group(115 cases)and the non-CAUTI group(5480 cases)based on whether they developed CAUTI during hospitalization.The risk factors and clinical characteristics of CAUTI among elderly hospitalized patients were analyzed.Results The total number of catheter-days for urinary catheterization was 40552.The infection rate of cases was 2.06%,and the thousand catheter-day infection rate was 2.84‰.Univariate analysis revealed that,in addition to gender,factors such as length of hospital stay,duration of indwelling urinary catheterization,and urine pH were all correlated with the occurrence of CAUTI(all P<0.001).Multivariate logistic regression analysis showed that urine pH≥6.5,moderate to severe dependency in self-care ability,female gender,hospital stay≥14 days,indwelling catheterization≥10 days,diabetes,and malnutrition were independent risk factors for CAUTI in elderly inpatients(all P<0.05).Patients in the CAUTI group had significantly higher rates of fever,abnormal procalcitonin levels,positive urine nitrite tests,detection of multidrug-resistant organism(MDRO),abnormal urination function,and admission by stretcher compared to the non-CAUTI group,with statistically significant differences observed for all comparisons(all P<0.001).Conclusions Urine pH≥6.5,moderate to severe dependency in self-care ability,and malnutrition are risk factors for CAUTI in elderly inpatients,and can be applied as new preventive and control strategies in clinical settings.Additionally,this study analyzed the clinical characteristics of CAUTI in the elderly through a large sample size,providing a reliable basis for its diagnosis and holding signifi

关 键 词：导尿管 老年人 住院病人 泌尿道感染 

分 类 号：R47[医药卫生—护理学]