肿瘤住院患者医院感染危险因素研究

Analytical study on nosocomial infections in tumor inpatients

目的分析研究肿瘤住院患者医院感染的现状、发病部位、感染病原菌的种类、易感因素,为临床医院感染的预防与控制提供科学依据。方法采取前瞻性与回顾性调查相结合的方法,对医院2011年1月-2011年12月肿瘤住院患者医院感染的临床资料进行分析。结果 19 201例住院患者发生医院感染113例,感染率0.60%;感染发生科室依次为肿瘤内科、外科、放疗科,分别占54.87%、19.47%、8.85%;感染发生部位依次为呼吸道、泌尿道、手术切口,分别占46.90%、12.39%、8.85%;共检出病原菌114株,其中革兰阳性球菌占17.54%,革兰阴性杆菌占59.65%,真菌占22.81%;检出率占前3位的病原菌,分别为大肠埃希菌与肺炎克雷伯菌、鲍氏不动杆菌、白色假丝酵母菌,分别占14.04%、13.15%、12.28%;抗菌药物的应用、使用激素、动静脉插管是导致肿瘤患者发生医院感染的重要因素,其分布分别为92.92%、76.11%、67.26%。结论肿瘤患者发生医院感染有其自身的特点,对其进行分析研究,并采取综合防治措施控制医院感染的发生。

OBJECTIVE To analyze the status of nosocomial infection in tumor inpatients, infection sites,pathogenic bacteria species and susceptible factors, and provide a scientific basis for clinical prevention and control of nosocomial infections. METHODS The prospective and retrospective investigation was used to analyze the data of nosocomial infections in tumor inpatients from Jan. 2011 to Dec. 2011. RESULTS In 19201 tumor inpatients, 113 patients developed nosocomial infections and the infection rate was 0.6 %. The infection departments included medical oncology, surgical oncology, and radiation therapy departments, accounting for 54. 87%, 19.47% and 8.85%, respectively. The infection sites included respiratory tract, genitourinary tract and surgical incision, accounting for 46.90 %, 12.39 ~ and 8.85 ~, respectively. A total of 114 strains of pathogens were isolated from the specimens with nosocomial infections, among which gram-negative bacteria accounted for 59.65%, followed by fungi （22.81%） and gram-positive bacteria （17.54 %）. The top three bacteria were Escherichia coli and Kleb- siella pneumoniae, Acinetobacter baurnannii, and Candida albicans, accounting for 14. 04%, 13. 15% and 12.28~, respectively. The main causes for nosoeomial infections were application of antibacterial drugs （with a distribution rate of 92. 92%）, use of corticosteroids （76. 11%） and arteriovenous catheterization （67. 26%）. CONCLUSIONS There are unique characteristics of nosocomial infection in tumor patients, which should be analyzed and researched and comprehensive measures should be taken to control the occurrence of nosocomial infections.