放疗中心医院感染的危险因素分析

Risk factors of nosocomial infections in radiation center

目的分析医院放疗中心医院感染的危险因素,并制定预防策略,以降低医院感染率。方法回顾性分析2008年5月-2012年5月在医院放疗中心治疗的1304例患者临床资料,对医院感染的各项危险因素进行单因素及多因素分析。结果共有90例患者发生医院感染,感染率6.9%,其中以呼吸系统感染率最高,占46.7%,其他依次为泌尿系统、消化系统及皮肤,分别占24.4%、15.6%及13.3%;单因素分析显示,高龄(>65岁)、白细胞计数<1.5×109/L、长期使用免疫抑制剂及广谱抗菌药物使用≥20d、住院时间>30d是医院感染的危险因素;logistic分析显示,长期使用免疫抑制剂危险性最大(OR=9.247),其他依次为广谱抗菌药物(OR=6.781)、高龄(OR=6.374)、白细胞计数(OR=5.647)、住院时间长(OR=4.247)。结论医院放疗中心医院感染的危险因素较多,治疗上应针对危险因素采取相应的预防对策,从而有效控制感染率。

OBJECTIVE To analyze the risk factors of nosocomial infections in the radiation center of Nanyang area and put forward the prevention measures so as to reduce the incidence of nosocomial infections.METHODS The clinical data of 1304cases of patients who underwent the radiotherapy from May 2008to May 2012were retrospectively analyzed,then the univariate analysis and the multivariate analysis of the risk factors were carried out.RESULTS The nosocomial infections occurred in 90patients with the infection rate of 6.9%,the incidence of the respiratory tract infections was the highest（46.7%）,followed by the urinary tract infections（24.4%）,gastrointestinal tract infections（15.6%）,and the herpes zoster（13.3%）.The univariate analysis indicated that the more than 65year of age,white blood cell count more than 1.5×109/L,long-term use of immunosuppressant and broad spectrum antibiotics,and the length of hospital stay more than 30days were the risk factors of the nosocomial infections;the logistic regression analysis showed that the long-term use of immunosuppressant ranked the greatest risk（OR=9.247）,followed by the use of broad spectrum antibiotics（OR=6.781）,the old age（OR= 6.374）,the white blood cell count（OR =5.647）,and the long length of hospital stay（OR =4.247）.CONCLUSIONThere are many risk factors of the nosocomial infections in the radiation center of Nanyang area,and the targeted prevention countermeasures should be adopted according to the risk factors so as to effectively control the nosocomial infections.