536例肾脏病患者医院感染的调查分析

Retrospectiveanalysisofhospital┐acquiredinfectionsin536patientswithrenaldiseases

目的：了解肾脏病患者医院感染情况，探讨与其相关的危险因素及预防措施。方法：回顾性分析了５３６例肾脏病患者中７３例符合医院感染诊断标准的临床资料。结果：肾脏病患者医院感染率为１３．６２％，其中狼疮性肾炎、糖尿病肾病、慢性肾功能衰竭感染率高。感染部位以泌尿道占首位，达５６．１％；其次胃肠道为１７．１％；下呼吸道及血液各占７．３％。绝大多数感染由机会致病菌引起，其中真菌感染占６２％，细菌感染占３８％，且普遍产生耐药性。真菌感染主要累及泌尿道、消化道及粘膜，细菌感染主要累及下呼吸道、血液、腹腔等部位。结论：医院感染与原发病自身特点、治疗、侵入性检查有关。

BJECTIVESIn-patientswithkidneydiseasesareexposedtoagreaterriskofhospital-acquiredinfec-tions,butuntilnowfewepidemicstudiesofthegroupofpatientshaseverbeenperformedinChina.Inordertoinvestigatetheclinicalcharacteristicsandrelatedriskfactorsofhospital-acquiredinfectionsinkidneydiseasepatients,aretrospectiveanalysiswasmade.METHODOLOGYClinicaldatain536patientswithkidneydiseasesfrom1993-1995werereviewedretrospectively,amongthem73patients'datacoincidedwiththediagnosticstandardofhospital-ac-quiredinfections.RESULTSTheincidenceofhospital-acquiredinfectionsinpatientswithkidneydiseasestotaled13.62%.Therewerehigherratesinpatientswithlupusnephritis(24.5%),diabeticnephropathy(21.4%)andchronicrenalfailure(16.7%).Thetopfrequentinfectionswereurinarytractinfection(56.16%)anddigestivetractinfection(17.1%).Mostoftheinfectionswerecausedbyopportunisticpathogensin-cluding62%bacteriaand38%fungiwhichusualyresultedinurinarytractordigestiveinfections.CONCLUSIONSStatisticsresultsindicatedthatincidenceofhospital-acquiredinfectionsinpatientswithkidneydiseaseswererelatedtolengthofhospitalstay,sortofprimarykidneydiseaseandimmuno-suppresivetherapy.Oldage,quantityofurinaryproteinandlevelofserumIgGwerealsoriskfactorsforinfectioninpatientswithkidneydisease.