医院真菌感染的危险因素分析

Risk factors of nosocomial fungal infection

目的探讨医院真菌感染的危险因素,为合理制定医院感染控制措施提供依据。方法医院真菌感染危险因素研究采用1∶1病例对照的研究方法,用Excel 2003软件建立病例和对照的资料数据库,核查无误后进行统计分析;采用SPSS12.0软件包对数据进行单因素条件logistic回归分析,计算各研究变量的OR值及其95%CI,再用逐步回归法将筛选出的各因素引入条件logistic多元回归。结果 logistic回归分析,发现与医院真菌感染发生有关的危险因素是年龄老化(≥55岁)(OR值为2.116,95%CI为1.020～4.389)、总住院时长(≥4周)(OR值为2.253,95%CI为1.214～4.180)、基础疾病(OR值为2.735,95%CI为1.332～5.615)、动静脉插管(OR值为3.643,95%CI为1.785～7.436)、抗菌药物的联用(OR值为7.143,95%CI为3.239～15.754)。结论医院真菌感染是一种多因素疾病,其发病主要是宿主因素和与医源性措施有关的因素共同作用的结果;调查结果提示这两个方面的因素均可不同程度地参与医院真菌感染的发生,各医院应针对医院感染发病的危险因素采取相应的医院感染监测和控制措施。

OBJECTIVE To investigate the risk factors of nosocomial fungal infection,to provide basis for formulating the control measures for nosocomial infection.METHODS A 1∶1 matched case-control study was carried out,the data of nosocomial fungal infection were analyzed by statistical techniques of Chi-square test and conditional logistic regression.RESULTS In the multiple conditional logistic regression model,aging（≥55 years）（OR 2.116,95%CI 1.020~4.389）,total length of stay（≥4W）（OR 2.253,95%CI 1.214~4.180）,arterial and venous cannula（OR 3.643,95%CI 1.785~7.436）,fundamental diseases（OR 2.735,95%CI 1.332~5.615 1.911,95%CI 1.377~2.652）and antibiotic combination（OR 7.143,95%CI 3.239~15.754） were significantly associated with increased risk of nosocomial fungal infection in all departments.CONCLUSION Nosocomial fungal infection is a disease with multiple risk factors,mainly includeing two aspects： the factors of patients themselves and the factors related to medical treatments.In this study,we find that the two aspects are connected with the emergence of fungal nosocomial infection in different degree.We should adopt corresponding measures to prevent nosocomial infection.