尘肺病患者医院感染危险因素分析

Risk factor analysis for nosocomial infection in pneumoconiosis patients

目的探讨尘肺病住院患者发生医院感染的状况并分析其危险因素。方法对本科2006年1月至2013年12月确诊为尘肺病的138例住院患者病例资料进行回顾性分析。结果 138例尘肺病患者中39例发生了医院感染,医院感染发生率为28.26%;检出病原菌16株,检出率为37.21%。单因素分析结果显示,感染组尘肺分期、住院时间、吸烟、血清白蛋白、抗生素使用时间与非感染组比较,差异有统计学意义（P〈0.05,P〈0.01）。多因素分析结果显示,尘肺分期（OR=0.019,P=0.004,95%CI：0.001-0.278）、住院时间（OR=1.085,P=0.001,95%CI：1.035-1.137）、抗生素使用时间（OR=1.112,P=0.024,95%CI：1.014-1.220）是其主要危险因素,而血清白蛋白（OR=0.841,P=0.012,95%CI：0.734-0.963）是其保护因素。结论尘肺病住院患者医院感染发生率较高,尘肺分期越严重、住院时间越长、使用抗生素时间越长、血清白蛋白越低,医院感染风险越大。

Objective To analyze the occurence of nosocomial infection in pneumoconiosis patients and the risk factors. Methods Retrospective analysis of pneumoconiosis patients from January 2006 to December 2013 in our hospital was performed. Results In 138 cases of pneumoconiosis patients,39 suffered from nosocomial infection,with the infection rate of 28. 26%. Sixteen strains of pathogenic bacteria were detected（37. 21%）. Single factor analysis showed that pneumoconiosis staging,hospital stay,unreasonable use of broad-spectrum antibiotics,hypoproteinemia and smoking were the risk factors of nosocomial infection of the pneumoconiosis patients. Multiple factors analysis showed that pneumoconiosis staging（ OR = 0. 019,P =0. 004,95% CI：0. 001 to 0. 278）,hospital stay（OR = 1. 085,P = 0. 001,95% CI： 1. 035 to 1. 137）,and unreasonable use of broad-spectrum antibiotics（OR = 1. 112,P = 0. 024,95% CI： 1. 014 to 1. 22） were the main independent risk factors,but serum albumin was a protective factor（OR = 0. 841,P = 0. 012,95% CI：0. 734 to 0. 963）. Conclusion The incidence of nosocomial infection in pneumoconiosis patients is relatively high. Pneumoconiosis staging,hospital stay and unreasonable use of broad-spectrum antibiotics are the main independent risk factors,but serum albumin is a protective factor.