类风湿关节炎医院感染临床特点分析

Characteristic analysis of nosocomial infection in Rheumatiod Arthritis

[目的]分析类风湿关节炎（RA）医院感染的临床特征，正确积极的防治医院感染。[方法]对2008年6月-2009年9月入住我院类风关内科的RA患者1020例进行回顾性研究，将入选的类风湿关节炎患者的病例信息进行详细登记，将所得数据进行汇总分析。[结果]调查的1020例RA患者，女性824例，男性196例，年龄17—92岁，平均年龄48岁。病程1个月-50年，平均病程8．47年。平均活动指数2．85。1020例患者中，发生院内感染316例，感染率为30．98％，其中男性44例，女性272例，男性女性感染率分别为22．45％和33．01％。尿路感染、下呼吸道感染、上呼吸道感染及阴道炎占总体医院感染的94．04％，不同部位的感染好发的病原体存在差异。319例进行了病原体培养，其中304例培养阳性，15例培养无病原菌生长。培养结果共检测出39种病原体391株，革兰阴性菌172株，革兰阳性菌100株，真菌7株，衣原体102株，其检出率分别为43．99％、25．58％、4．34％和26．09％。男性医院感染以呼吸系统为主，而女性以尿路感染为主。[结论]本组风湿关节炎医院感染发生率高于国内平均水平，且支原体感染高于其他病种。医院感染的病原体谱逐年发生变化，耐药性也在改变。

[ Objective ] To observe the etiological characteristics of nosocomial infection in Rheumatiod Arthritis and take positive prevention action. [ Methods ] A total of 1020 patients with RA were studied who were admitted to GuangHua Hospital between June 2008 and September 2009. Their basis information and cases feature were registered in detail. The items for analysis included patient＇s age, gender, medicine for treatment, leucocyte count, lymphocyte count, ESR, CRP etc. [ Results] Of the 1020 patients investigated, 824 were female, and 196 male ~ Both female and male patients ranged in age from 17 to 92 years old, with their average age being 48 years old, and disease course 8.47 years. There were 316 patients who suffered from nosocomial infecton, of whom 272（the infection rate,33.01% ） were female and 44 male（22.45 % ） , the infection rate being 30.98%. As to affected sites and occurrence rate, in urinary tract, upper and lower respiratory tracts and vagina, infection accounted for 94.04% of the total. And 304 pathogens were isolated, of which Gramnegative bacteria were 172, Gram -positive 100, mycotic 7 and chlamydial 102, accounting for 43.99%, 25.88%, 4.34% and 26.09% respectively. [ Conclusion ] The nosocomial infection in RA was much higher than the average level, higher in female than in male, and chlamydial in- fection held a higher level than other diseases. Pathogenic spectrum changed year by year.