肿瘤患者合并医院感染调查分析

Investigation and analysis of nosocomial infections in tumor patients

目的调查肿瘤科患者合并医院感染的特征,探讨其相应对策。方法回顾性调查1280例肿瘤患者的临床资料。结果 1280例肿瘤患者合并医院感染260例,感染率为20.3%;以呼吸系统为主共105例;送标本培养240份,检出病原菌110株,阳性率为45.8%;其中革兰阴性菌50株占45.4%,革兰阳性菌40株占36.4%,真菌20株占18.2%;年龄大、化疗次数多、预防应用抗菌药物、侵入性操作、住院时间长是医院感染的危险因素;感染组死亡率为15.4%。结论肿瘤科患者医院感染可加重病情,应提高高龄患者机体免疫力;掌握抗菌药物适应证;严格遵守无菌操作;缩短住院日创造条件以减少医院感染的发生。

OBJECTIVE To investigate the characteristics of nosocomial infections in cancer patients in tumor department and explore the corresponding countermeasures. METHODS By the means of retrospective survey, the clinical data of 1280 tumor patients were investigated. RESULTS Nosocomial infections occurred in 260 of 1280 cancer patients with the infection rate of 20.3%; the respiratory tract was the major site with infections; totally 110 strains of pathogens were isolated from 240 patients submitted with the positive rate of 45.8% ; there were 50 （45.4%） strains of gram-negative bacteria ,40 （36.4%） strains of gram-positive cocci, and 20 （18.2%） strains of fungi; the aged, frequent chemotherapy, prophylactic use of antibiotics, invasive operation, and long hospital stay were the risk factors for nosocomial infections; the mortality was 15. 4% in the infection group. CONCLUSION The nosocomial infection can exacerbate the condition of the cancer patients, it is necessary to improve the immunity of the elderly patients, master the antibiotics indications, strictly obey the aseptic operation ,and shorten the hospital stay so as to reduce the nosocomial infections.