老年骨科住院患者医院感染临床分析及预防对策

Clinical analysis of nosocomial infection in elderly hospitalized orthopaedic patients and preventive strategy

目的探讨老年骨科住院患者医院感染的发生特点,提出预防对策及控制措施,以有效预防及控制医院感染的发生。方法对2010-2011年1 157例老年住院骨科患者并发医院感染的临床资料进行回顾性分析,采用Excel进行数据录入和SPSS16.0软件进行统计分析,计数资料用率表示,采用χ2检验。结果 1 157例住院患者中发生医院感染127例、131例次,医院感染率10.98%、例次感染率11.32%,2011年感染率较2010年显著下降,差异有统计学意义(P<0.05);感染部位以下呼吸道、泌尿道、牵引眼为主,分别占70.99%、12.98%、12.21%;共分离出病原菌146株,其中革兰阴性菌100株占68.49%,以肺炎克雷伯菌、鲍氏不动杆菌为主,分别占21.92%和14.38%;革兰阳性菌31株占21.23%,以金黄色葡萄球菌和溶血性链球菌为主,分别占8.90%和4.79%;真菌15株,占10.28%,以白色假丝酵母菌为主,占9.59%。结论老年骨科住院患者医院感染率较高,医务人员应引起高度重视,强化业务培训及相关知识的学习,采取有针对性的医院感染防范措施,以降低医院感染的发生。

OBJECTIVE To investigate the characteristics of nosocomial infections in elderly hospitalized orthopaedic patients and to put forward some preventative and control measures so as to effectively prevent and control the nosocomial infections.METHODS The clinical data of 1157cases of elderly hospitalized orthopaedic patients who were complicated with nosocomial infections were retrospectively analyzed,Excel software was adopted for data input,SPSS 16.0software was adopted for statistical analysis;enumeration data was expressed by rate and Chisquare test was adopted for test.RESULTS Among the 1157hospitalized patients,nosocomial infections occurred in 127patients and 131case-times in total,with the nosocomial infection rate of 10.98%,and the case-times infection rate of 11.32%.The infection rate in 2011was significantly lower than that in 2010.Lower respiratory tract, urinary tract and bone traction site were the dominant infection sites,accounting for 70.99%,12.98%,and 12.21%respectively;a total of 146strains of pathogens were isolated,including 100strains of gram-negative bacteria accounted for 68.49%,with Klebsiella pneumonia and Acinetobacter baumannii dominantly accounting for 21.92%and 14.38%respectively;31strains of gram-positive bacteria accounted for 21.23%,with Staphylococcus aureus and Hemolytic streptococcus dominantly accounting for 8.90% and 4.79% respectively;15strains of fungi accounted for 10.28%,with Candida albicans dominantly accounting for 9.59%.CONCLUSIONThe nosocomial infection rate in elderly hospitalized orthopaedic patients is high,so the medical workers should pay high attention to it,strengthen professional training and study of relevant knowledge,and take specific preventive strategy for nosocomial infection so as to reduce the incidence of nosocomial infection.