老年住院患者导尿管相关尿路感染的流行病学特征和危险因素分析  

Epidemiological features and risk factors analysis of catheter-associated urinary tract infection in elderly inpatients of geriatric medicine department

作　　者：杜凤英 刘一凡 Du Fengying;Liu Yifan(Infection Management Department,Suqian Hospital of Jiangsu Provincial People's Hospital(Suqian First People's Hospital),Suqian 223800,China;Rehabilitation Medicine Department,Suqian Hospital of Jiangsu Provincial People's Hospital(Suqian First People's Hospital),Suqian 223800,China)

机构地区：[1]江苏省人民医院宿迁医院(宿迁市第一人民医院)感染管理处,宿迁223800 [2]江苏省人民医院宿迁医院(宿迁市第一人民医院)康复医学科,宿迁223800

出　　处：《中华老年病研究电子杂志》2024年第4期26-30,共5页Chinese Journal of Geriatrics Research(Electronic Edition)

基　　金：江苏省卫生健康委预防医学科研课题面上项目(Ym2023100)

摘　　要：目的了解老年住院患者导尿管相关尿路感染(CAUTI)的现状,分析CAUTI发生的危险因素。方法通过杏林院感监测系统收集宿迁市第一人民医院老年医学科2019—2023年收治的210例尿管置入老年患者的资料,根据是否发生CAUTI分为感染组(10例)和非感染组(200例)。分析导尿管使用率、CAUTI发病率、感染病原菌分布等;运用单因素分析比较两组患者的相关资料,筛选出有意义变量纳入多因素Logistic回归分析,预测CAUTI的危险因素。结果老年住院患者导尿管使用率为6.02%,CAUTI发病率为4.36‰;CAUTI在全部感染和泌尿系感染中的占比分别为16.39%和47.62%;感染的病原菌共10株,其中真菌6株,革兰阴性菌4株。Logistic回归分析结果显示,使用糖皮质激素≥3 d是CAUTI发生的独立危险因素(OR=5.173,95%CI=1.007~26.561,P<0.05)。结论本组老年住院患者CAUTI发病率高且呈增加趋势,真菌感染居多,使用糖皮质激素≥3 d的患者尤其需要警惕CAUTI的发生。Objective To investigate the current status of catheter-associated urinary tract infections(CAUTI)in hospitalized patients in the geriatrics department,and analyze the risk factors for the occurrence of CAUTI.Methods Through the Xinglin Hospital Infection Monitoring System,data from 210 patients with urinary catheters in the geriatrics department of Suqian hospital from 2019 to 2023 were retrospectively collected.The patients were divided into infection group(n=10)and noninfection group(n=200)based on the occurrence of CAUTI.Analyze the catheter utilization rate,CAUTI incidence,and distribution of pathogenic microorganisms.Univariate analysis was employed to compare the relevant data between the two groups,and significant variables were included in multivariate logistic regression analysis to predict the risk factors for CAUTI.Results The urinary catheter utilization rate among hospitalized patients in the geriatrics department was 6.02%,with a CAUTI incidence rate of 4.36‰.CAUTI accounted for 16.39%of all infections and 47.62%of urinary tract infections.A total of 10 pathogenic strains were identified,including 6 fungal strains and 4 Gram-negative bacterial strains.Logistic regression analysis revealed that the use of glucocorticoids for≥3 days was an independent risk factor for the occurrence of CAUTI(OR=5.173,95%CI=1.007-26.561,P<0.05).Conclusion The incidence of CAUTI in the geriatrics department of the hospital is high and shows an upward trend,with fungal infections being predominant.Patients using glucocorticoids for≥3 days require particular vigilance for the occurrence of CAUTI.

关 键 词：导尿管相关尿路感染 老年医学科 住院患者 导尿管使用率 病原菌 危险因素 

分 类 号：R691.3[医药卫生—泌尿科学]