病毒性肝炎住院患者医院感染的调查分析

A survey on nosocomial infections in patients with viral hepatitis

目的对传染病专科医院病毒性肝炎患者医院感染现患率及影响因素进行调查．方法1996－03-01／07－30收治各型病毒性肝炎患者595例，男487例，女108例，年龄1．5岁～72岁，平均37岁．各型肝炎诊断依据1990年全国第六次病毒性肝炎学术会议（上海）修订的标准。医院感染诊断标准：参照郑明新等主编的《医院感染》各部位感染诊断标准判定医院感染情况。结果研究对象中有55例发生医院感染，感染发生率9．2％，感染次数为67例次，感染例次率11．3％其中死亡病例13例，病死率为2．2％，其中未发生医院感染者的病死率为1．5％（8／540），发生医院感染的病死率9．1％（5／55）．死亡患者医院感染发生率为38．5％（5／13），感染例次率为76．9％（10例次／13例）．医院感染部位分布于腹腔（21例）、呼吸系统（18例）、泌尿生殖系统（6例）、口腔（6例）。胃肠道系统和皮肤软组织（各2例）．发生医院感染者中有26例次进行了病原微生物检查，送检率为38．8％，病原学检查阳性的有18例次，阳性率为69．2％．结论传染病专科医院肝炎患者医院感染发生率与全国综合医院的平均感染率相当，肝硬变、重度慢性肝炎患者是医院感染的高发人群，预后差，死亡率高。感染的发生还与患者的病理状态、住院时间、有无创性介入检查史?

AIM To investigate the incidence and risk factors of nosocomial infections in petients with viral hepetitis.METHODS From March to July 1996, 595 patients with viral hepatitis were investigated. Of all the patients, 487were men, 108 were waren, aged from 1.5 to 72 years.Diagnosis of hepetitis is according to 'The diagnostic standerd of viral hepetitis revised in Shanghai, 1990', and the evaluation of nosocomial infections is according to 'Nosocomial infection' (Edited by Zheng MX).RESULTS Sixty-seven occasions of nosocomial infections occured in 55 of 595 patients and the incidence was 9.2%. The infection sites were distributed in abdominal cavity (n = 21), respiratory system (n = 18 ),urogenitaI system (n = 6), mouth cavity (n = 6), digestive sysbo (n = 2 ), and skin and soft tissue (n = 2 ).Pathogenic bacteria were examined in 26 cases, and 18 samples were positive with a positive rate of 69. 2%.CONCLSION The incidence of nosocomial infections in a infectious diseases hospital is similar to the average rate in gerneral hospitals in China. The patients with cirrhosis or severe chronic hepatitis have higher nosocomial infectious prabability, with unfavourable prognosis and higber mortality. The incidence of nosocomial infections is related to patients pathological state, the duration of hospitalization, the aspiration biopsy or/and catherterizations, and utilization of antimicrobial agents or immunosupressant treatment or prophylaxis.