糖尿病患者医院感染的临床特征分析

Clinical characteristics of nosocomial infections in hospitalized diabetes patients

目的探讨糖尿病医院感染的临床特点及预防对策。方法调查920例糖尿病患者病案资料,统计医院感染发生率、感染类型、病原菌分布,分析引起医院感染的相关因素及发生医院感染对糖尿病预后的影响。结果糖尿病患者医院感染率9.78%,呼吸道感染最多,占38.89%,其中21.11%临床症状不典型;病原学呼吸道以肺炎克雷伯菌感染为主、泌尿系感染以大肠埃希菌为主、皮肤感染见于金黄色葡萄球菌及白色假丝酵母菌;医院感染患者平均年龄、合并慢性并发症、侵入性操作、血糖水平、预防用药、住院时间、医院感染病死率均高于非感染组。结论糖尿病合并医院感染发生率较高,影响因素复杂,对预后有不良影响,积极控制血糖、改善高龄患者营养状况、合理应用抗菌药物、尽量减少侵入性操作、缩短住院时间有利于减少或避免医院感染发生。

OBJECTIVE To explore the clinical characteristics of nosoeomial infection in the diabetes patients so as to propose the prevention countermeasures. METHODS The medical records of 970 diabetes patients were investigated, the incidence of nosocomial infections, types of the nosocomial infections, and the distribution of pathogens were statistically analyzed. The related factors associated with the nosocomial infections were analyzed, and the effect of the incidence of nosocomial infections on the prognosis of diabetes was evaluated. RESULTS The incidence of nosocomial infections in the diabetes patients was 9.78%, the patients with respiratory tract infections took the largest proportion, accounting for 38. 89%, and 21. 11% of the patients were with atypical clinical manifestations. The Klebsiella pneumoniae was the main species of pathogens causing respiratory tract infections, the Escherichia coli was dominant in the Pathogens causing the urinary tract infections, and the Staphylococcus aureus and Candida albicans were the predominant species of pathogens causing skin infections. The average age, combination with chronic complications, invasive operation, blood glucose level, antibiotics prophylaxis, hospital stay, and the mortality were higher in the nosocomial infection group than in the non-infection group. CONCLUSION The incidence of the nosocomial infections is high in the diabetes patients, the impact factors are complex and have bad effect on the prognosis. It is an effective way to control and avoid the nosocomial infections by actively controlling the blood glucose ,improving the nutritional status of the elderly patients, reasonably using antibiotics, reducing the invasive operations, and shortening the hospital stay.