113838例住院患者医院感染及危险因素的logistic回归分析

Risk factors for nosocomial infections in 113838 cases of inpatients:a logistic regression analysis

目的探讨医院感染流行趋势,确定相关危险因素及其影响程度。方法调查2002-2009年113 838例住院患者医院感染情况,对可能危险因素进行logistic回归分析。结果医院感染率为2.53%,以上呼吸道感染最高,占36.77%,其余依次为下呼吸道占24.09%、泌尿道占17.49%、胃肠道占7.00%、皮肤软组织占5.22%等;性别、年龄、住院天数、免疫抑制剂、化疗I、CU、血液病、糖尿病、肝病、精神病、抗菌药物、骨腰穿、尿路插管及动静脉插管、呼吸机、气管切开、急诊手术、其他慢性病和侵入性操作等19项因素是医院感染的独立危险因素。结论医院感染控制不平衡,但总体好转,应根据危险因素制定控制措施。

OBJECTIVE To probe into the prevalent tendency of nosocomial infection,determine the risk factors and the impact of the risk factors.METHODS A total of 113 838 inpatients were investigated by case recorder for nosocomial infection and possible risk factors during 8 years in our hospital,and these factors were analyzed by logistic regression analysis.RESULTS 2.53% of inpatients suffered from the nosocomial infection.The frequent infection site were upper respiratory tract（36.77%）,lower respiratory tract（24.09%）,urinary tract（17.49%）,gastrointestinal（7.00%）,skin soft tissue（5.22%）.The independent risk factors were sex,age,length of hospital stay,chemotherapy,ICU,liver disease,mental illness,antibiotics,urinary catheterization,vascular catheter,ventilator,tracheotomy and emergency surgery.CONCLUSIONS The control of nosocomial infection of our hospital is unbalanced,but has been improved generally,we need to develop the measures based on the risk factors.