长期卧床老年患者医院获得性尿路感染的临床分析

Bedridden elderly patients with hospital-acquired urinary tract infections in clinical analysis

目的了解长期卧床老年患者医院获得性尿路感染的危险因素和病原菌分布特点,以制定预防和控制医院感染方案,降低医院感染发生率。方法对医院2011年6月-2012年8月老年病房住院患者发生尿路感染及相关因素进行回顾性调查分析,按操作规程进行细菌、真菌培养和菌落计数,应用法国生物梅里埃公司VITEK-32细菌鉴定仪,对检出的病原菌采用K-B琼脂扩散法进行药物敏感试验;应用SPSS10.0软件进行统计统计分析。结果 578例住院患者发生尿路感染45例,感染率7.79%;检出革兰阴性菌35株占77.77%,以大肠埃希菌、奇异变形菌、肺炎克雷伯菌为主,分别占24.44%、17.78%、13.33%,革兰阳性菌8株占17.78%,以粪肠球菌、屎肠球菌为主,各占4.45%,真菌以白色假丝酵母菌为主占4.44%;高龄、住院和卧床时间长、基础疾病多、侵入性操作及不合理使用抗菌药物是发生尿路感染的危险因素。结论老年患者尿路感染危险因素多,必须制定有针对性的预防控制措施,有效降低医院感染的发生。

OBJECTIVE To learn the pathogen distribution and risk factors of hospital-acquired urinary tract infections in bedridden elderly patients, so as to develop prevention and control of hospital infection program and reduce the incidence of nosocomial infections. METItODS A retrospective investigation about urinary tract infections and related factors inpatients in geriatric ward from Jun. 2011 to Aug. 2012 were taken. Bacteria, fungi culture and colony counting were processed based on the operating instruction. VITEK-32 bacteria identification instrument was used for drug sensitivity test to detected pathogen in K-B agar diffusion method. SPSSI0. 0 software was used for statistical analysis. RESULTS Among the 578 cases of inpatients, 45 cases with urinary tract infections, accounting for 7.79 %. A total of 35 strains of gram-negative bacterium were detected, accounted for 77. 78%, among which Escherichia coli, Proteus rnirabilis and Klebsiella pneurnoniae were the top three, accounting for 24. 44%, 17. 78% and 13.33M respectively. Gram-positive bacteria accounted for 17. 78%, 8 strains, among which Enterococcus faecalis and E. faecium were the most ones, accounting for 4. 45% and 4.45%, respectively. Candida albicans was the top one in fungi, accounting for 4.44%. Elderly, hospitalized and in bed for a long time, many underlying diseases, invasive procedures and irrational use of antibiotics were risk factors for urinary tract infections. CONCLUSIONS Elderly patients have multiple risk factors for urinary tract infections. Therefore, it must develop targeted prevention and control measures to effectively reduce the incidence of nosocomial infections.