结核病患者医院感染的分析与对策

Analysis and Control Strategies of Nosocomial infection of Tuberculosis Patients

目的分析结核病患者医院感染的临床特点及危险因素,以有效控制感染的发生。方法回顾性分析广西龙潭医院2005—2007年5791例结核病患者医院感染的临床资料。结果1692例患者并发医院感染,感染率为29.22%;感染部位以肺部为主,为67.71%;其次是肺外的呼吸道部份,感染率为24.65%。引起感染的病原菌种类以革兰阴性菌为主,占50.67%。真菌感染也占较大比例,为18.52%,以白色念珠菌为主。感染与年龄、住院时间、侵袭性操作和广谱抗生素、免疫抑制剂的使用等因素有关。结论结核病易导致医院感染,必须加强医院感染的管理,控制易感因素,规范抗生素的使用,以减少医院感染的发生。

[ Objective] To study clinical characteristics and risk factors of nosocomial infection of tuberculosis （TB） patients, so as to effectively control the infection. [Methods] Clinical information of 5791 cases of TB patients with nosocomial Infection in Longtan Hospital of Guangxi during 2005--2007 was retrospectively analyzed. [ Results] Totally 1692 patients were complicated by nosocomial Infection, infection rate was 29.22% ; lung was the major infection site, occupied 67.71% ; followed by respiratory infection {24.65%）. Gram-negative bacteria was the major pathogens （50.67% ）. Fungal infection accounted for a large proportion of 18.52% ,taking Candida albicans as majority. Infection related with age, length of hospitalization and invasive operation as well as the use of broad-spectrum antibiotics and immunosuppressive agents. [ Conclusion] TB is easily lead to nosocomial infection, intensive nosocomiall infection management should be enhanced, the risk factors of the infection should be controlled and antibiotic should be used rationally to reduce the nosocomial infection on TB patients.