住院患者医院感染影响因素及防控对策分析

Analysis of risk factors for nosocomial infections in inpatients

目的分析住院患者医院感染的风险影响因素,明确感染发生的原因,探讨预防感染风险发生的策略,保护患者和医务人员的健康。方法对医院2012年1～10月住院的6930例入院患者采用回归分析法进行研究,通过查阅、整理相关资料,分析患者医院感染发生率、感染部位、病原菌特征及高危影响因素。结果发生医院感染共473例,感染率为6.83%;感染率较高的科室分别为神经内科27.73%、神经外科12.22%,肿瘤科11.59%,心血管呼吸内科9.63%,消化内分泌科9.18%,中医科8.31%;感染部位以呼吸道、泌尿道和消化道为主;共检出病原菌131株,以革兰阴性杆菌为主,占47.33%。医院感染的高危因素主要有基础疾病,住院时间过长,侵袭性操作,滥用抗生素等。结论积极治疗基础性疾病,严格遵守操作规范,合理使用抗菌药,缩短住院时间,可有效预防和控制医院感染的发生和发展。

Objectives To analyze risk factors for nosocomial infections in inpatients, clearly identify causes of infections, determine strategies to prevent infection, and protect the health of patients and medical staff. Methods Regression analysis was used to study 6,930 patients hospitalized from January to October 2012. Relevant data were referred to and assembled to analyze the incidence of nosocomial infections in patients, the site of infection, the characteristics of the pathogens responsible, and factors for an increased risk of infection. Results Four hundred and seventy-three patients developed a nosocomial infection for a rate of infection of 6.83%. Departments with a higher rate of infection were Neurology （27.73%）, Neurosurgery （12.22%）, Oncology （11.59%）, Cardiovascular and Respiratory Medicine （9.63%）, Gastrology and Endocrinology （9.18%）, and Traditional Chinese Medicine （8.31%）. The site of infection was primarily the respiratory tract, urinary tract, or gastrointestinal tract. In total, 131 pathogenic strains were detected. Most were Gram-negative bacilli, accounting for 47.33%. The risk factors for nosocomial infection were having an underlying disease, prolonged hospitalization, undergoing an invasive procedure, and misuse of antibiotics. Conclusion Active treatment of underlying diseases, strictly adherence to protocols, rational use of antimicrobials, and a reduced duration of hospitalization can effectively prevent and control the incidence and development of nosocomial infections.