住院肝硬化患者医院感染的危险因素分析

Risk Factors of Nosocomial Infection among 621 Inpatients with Cirrhosis

目的探讨住院肝硬化患者医院感染的危险因素,为制定针对性的预防措施提供科学依据。方法回顾性分析2006年—2010年我院住院肝硬化患者共621例的临床资料,记录患者医院感染发生率、感染部位及病原菌分布情况,对患者医院感染的相关危险因素进行分析。结果 621例住院肝硬化患者共96例发生医院感染,共计129例次,医院感染发生率为15.46%(96/621);感染部位由多到少依次为:呼吸道、腹膜、泌尿道、胃肠道、皮肤、胆管、口腔;共分离出病原菌78株,由多到少依次为:大肠埃希菌、肺炎克雷伯杆菌、白色假丝酵母菌、金黄色葡萄球菌、鲍氏不动杆菌、溶血性葡萄球菌、肺炎链球菌、酿脓链球菌。不同年龄、住院时间、白细胞计数、清蛋白水平、肝功能分级、有无侵入性操作、有无并发症及是否预防性使用抗菌药物的住院肝硬化患者医院感染发生率比较,差异均有统计学意义(P<0.05)。结论住院肝硬化患者医院感染发生率较高,引起感染的危险因素较多,应采取综合防治措施,以降低患者医院感染发生率。

Objective To analyze the risk factors of nosocomial infection among 621 inpatients with cirrhosis. Methotis The clinical data of 621 cirrhotic inpatients who were treated in our hospital from 2006 to 2010 were retrospectively reviewed. Results Of these 621 patients, nosocomial infections were identified in 96 patients （ 129 times） , yielding a percentage of 15.46%. The most commonly infected sites were respiratory tract, peritoneum, urinary tract, gastrointestinal tract, skin, bile duct, and oral cavity. Totally 78 bacterial strains were isolated, including Escheriehia coli, Klebsiella pneumoniae, Candida alhicans, Staphylococcus aureus, Acinetobacter baumanni, hemolytic Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes and Streptococcus pyogenes. The incidence of nosocomial infection showed significant differences in terms of age, hospital stay, white blood cell count, albumin level, liver function, with or without invasive procedures, with or without complications, and prophylactic use of antimicrobial drugs （ P 〈 0. 05 ）. Conclusion Cirrhotic inpatients tend to have relatively high incidence of nosocomial infection due to various risk factors.