糖尿病住院患者合并医院感染的特点观察

Characteristics of Nosocomial Infection in Diabetic Inpatients

目的探讨糖尿病住院患者合并医院感染的特点。方法 2006年1月-2008年12月收治的住院糖尿病合并医院感染患者共80例作为观察组,按照1∶2比例选择无医院感染的糖尿病住院患者160例作为对照组,分析两组患者的临床资料及医院感染部位与构成比,医院感染病原菌检查结果,医院感染对预后的影响。结果 80例观察组中呼吸道感染25例居首位(31.25%)、其次泌尿道感染22例(27.50%);具有感染典型表现52例(65.00%),28例症状不典型(35.00%);送标本190份,检出病原菌124株(65.26%),培养革兰阴性菌56株(45.16%),革兰阳性菌44株(35.48%),真菌24株(19.36%);医院感染相关因素为年龄大?病程长、血糖水平高、侵入性操作比例高、合并糖尿病并发症、基础疾病多、住院时间长;预防应用抗菌药物差异无统计学意义;80例观察组中死亡6例,高于160例对照组中死亡4例。结论糖尿病发生医院感染难以完全避免,发生与诸多因素有关,可增加病死率;应通过治疗原发病、合理应用抗菌药物、减少侵入性操作、缩短住院时间等以预防及减少医院感染的发生。

OBJECTIVE To Explore the characteristics of nosocomial infection in diabetic inpatients.METHODS From Jan 2006 to Dec 2008 80 diabetes mellitus cases with nosocomial infection as the observation group were treated in the hospital,and by the 1∶2 ratio 160 diabetes inpatients without nosocomial infection were selected as the control group to and their clinical data,site of nosocomial infection,composition ratio of pathogens and prognosis were analyzed.RESULTS From 80 cases in the observation group 25（31.25%）cases were with the respiratory tract infection and 22 cases with the urinary tract infection;the infection in 52（65.00%）cases was typical vs 28（35.00%）atypical cases;from 190 samples were detected 124（65.26%） strains of pathogens there were 56（45.16%） strains of G-bacteria,44（35.48%） of G＋ bacteria and 24（19.35%） of fungi;the nosocomial infection-related factors were older,longer duration,higher blood glucose levels,a high proportion of invasive operation,diabetes complications,underlying of diseases and more long hospital stay;the preventive use of antibiotics was without significance;in the observation group there were six died cases vs 4 in the control group.CONCLUSIONS The nosocomial infection in diabetes can not be completely avoided,and its occurrence related with a number of factors and can increase mortality.Through treatment of the primary diseases,rational application of antibiotics,reducing the invasive operation and shortening the duration of stay could to prevent and lower the incidence of nosocomial infection.