医院内菌血症危险因素病例对照研究

A Matched Case-control Study on Risk Factors of Bacteriemia

目的 探讨医院内菌血症的危险因素。方法 于1999年 4～ 12月在福州市对某医院 1994年 1月至 1997年 12月间发生医院内菌血症住院病人进行 1∶1配对病例对照研究。结果 单因素卡方分析发现 ,住院时间超过 30天、应用丙种球蛋白、应用抗生素、重症监护、导尿、动静脉导管、其它介入性诊治、血白蛋白低、贫血、输血等 10个因素与病人医院内菌血症有显著性关联 ;条件Logistic多元回归模型分析表明动静脉导管、贫血、重症监护和住院时间超过 30天是引起医院内菌血症的主要独立危险因素。而且趋势 χ2 分析发现 ,贫血程度越严重、住院时间越长 ,病人发生医院内菌血症的风险就越大。结论 减少动静脉导管或缩短其留置时间、积极治疗贫血对预防和控制医院内菌血症有十分重要的意义。

Objective This study aimed at exploring the risk factors for bacteriemia.Methods A 1∶1 matched case control study with 125 pairs on risk factors of bacteriemia was carried out in Fuzhou city in 1999.The available data were analyzed by Chi square test and multiple logistic regression model.Results Chi square test showed that bacteriemia was significantly associated with long time hospitalization,expose to intensive care unit,anemia,arteriovenous catheter,the other invasive diagnosis and treatment procedures,transfusion,unsuitable application of antibiotics,urinary catheter,application of immunoglobulin,and low albumin.The multivariable conditional logistic regression analysis showed that bacteriemia was significantly associated with long time in hospitalization(with OR of 11 2,P<0 0001),arteriovenous catheter(with OR of 6 2,P<0 05),anemia(with OR of 6 0,P<0 0001),expose to intensive care unit(wiht OR of 3 5,P<0 01).Conclusion It suggests that occurence of bacteriemia may correlate to long time in hospitalization,arteriovenous catheter,anemia and expose to intensive care unit.