258例下呼吸道医院感染患者的状况调查分析及对策

目的了解患者下呼吸道医院感染状况。方法对2007年1-12月24308例住院患者,发生下呼吸道医院感染的258例患者的临床资料进行回顾性调查分析。了解患者医院感染情况及年龄、基础疾病、应用抗菌药物情况及侵入性医疗护理操作等与下呼吸道医院感染的关系。结果年龄<60岁患者感染77例(占29.84%),≥60岁患者181例(占70.16%);感染率高患者前3种疾病分别为:颅脑脊髓外伤及病变102例(占39.54%)、呼吸系统疾病50例(占19.38%)、消化系统疾病42例(占16.28%);感染患者实施医疗护理情况分别为应用高效广谱抗生素177例(占68.60%),实施泌尿道插管80例(占31.01%),使用呼吸机75例(占29.07%),实施动静脉插管58例(占22.48%),营养不良50例(占19.38%);在110株感染病原菌中前3位分别为金黄色葡萄球菌29株(占26.36%),铜绿假单胞菌20株(占18.18%),肺炎克雷伯菌14株(占12.72%)。结论下呼吸道医院感染主要与患者年龄、基础疾病有关,感染患者较集中在使用高效广谱抗生素药物,实施袭入性操作及低抵抗力的患者。

Objective To investigate the status of lower respiratory tract cross-infection within a hospital and explore the risk factors.Methods We retrospectively reviewed the histories of 258 patients with lower respiratory tract infection from 24 308 inpatients with nosocomial lower respiratory tract infection from January 2007 to December 2007 for the purpose of exploring the relationships of nosocomial infection of the patients,age,primary disease,use of antibiotics,and invasive medical procedures with lower respiratory tract infection within the hospital.Results The infection rates for those aged less than 60 years and those more than and due 60 years were 29.84% and 70.16%,respectively.The first 3 diseases in the patients with high infection rate were traumatic injury and lesions in brain and spinal cord （39.54%）,respiratory disease （19.38%）,digestive diseases （16.28%）.The medical and nursing procedures status included antibiotic treatment （68.60%）,catheterization treatment （31.01%）,use of breathing machine （29.07%）,arterial and venous cannulation （22.48% ）,and malnutrition （19.38% ）.The top 3 bacteria were staphylococcus aureus （26.36% ）,pseudomonas aeruginosa （18.18% ） and klebsiella pneumonia （12.72% ）.Conclusion The lower respiratory tract cross-infection within a hospital is associated with age,primary diseases,use of efficient broad -spectrum antibiotics,invasive medical procedures and poor immunity.