肺结核患者医院感染易感因素分析

Risk factors for nosocomial infections in patients with pulmonary tuberculosis

目的探讨肺结核患者发生医院感染的易感因素,制定预防对策,为预防肺结核医院感染提供指导。方法选择2012年6月-2013年6月的316例肺结核患者作为研究对象,统计出现医院感染的病例数,分析患者的临床资料,探讨肺结核患者发生医院感染的危险因素。结果 316例肺结核患者发生医院感染30例,感染率9.49%;医院感染部位以下呼吸道为主,感染16例,占53.33%,其次为泌尿道和胃肠道,分别占20.00%和13.33%;年龄≥60岁患者感染率为14.96%、<60岁的为5.82%,住院时间≥15d的患者感染率为12.88%、<15d的感染率为7.07%,应用多种抗菌药物的患者感染率为14.06%,未应用多种抗菌药物的为6.38%,有并发症的患者感染率为12.70%,无并发症患者感染率为7.37%,实施侵入性操作的患者感染率为20.27%、未实施为6.20%;年龄≥60岁、住院时间≥15d、合并其他疾病、侵入性操作、应用多种抗菌药物等为肺结核患者医院感染危险因素(P<0.05)。结论高龄、住院时间长、抗菌药物应用多种、伴有其他疾病、侵入性操作等为肺结核患者发生医院感染的易感因素,应采取针对性的预防对策降低其医院感染率。

OBJECTIVE To explore the risk factors for nosocomial infections in the patients with pulmonary tuber-culosis and put forward prevention countermeasures so as to provide guidance for prevention of pulmonary tubercu-losis. METHODS A total of 316 patients with pulmonary tuberculosis who were treated in the hospital from Jun 2012 to Jun 2013 were enrolled in the study, the number of cases of nosocomial infections was taken for statistics, the clinical data of the patients were analyzed, and the risk factors for the nosocomial infections were explored. RESULTS The nosocomial infections occurred in 30 of 316 patients with pulmonary tuberculosis, with the infection rate of 9. 49%, among whom the patients with lower respiratory tract infections accounted for 53. 33% （16 ca-ses）, the patients with urinary tract infections 20. 00%, the patients with gastrointestinal tract infections 13. 33%. The incidence of infections was 14. 96% in the patients aged no less than 60 years old, 5. 82% in the pa-tients aged less than 60 years old, 12. 88% in the patients with the length of hospital stay no less than 15 days, 7. 07% in the patients with the length of hospital stay less than 15 days, 14. 06% in the patients who used multi-ple antibiotics, 6. 38% in the patients who did not use multiple antibiotics, 12. 70% in the patients complications, 7. 37% in the patients without complications, 20. 27% in the patients who underwent invasive operations, 6. 20% in the patients who did not undergo invasive operations ;the no less than 60 years of age, length of hospital stay no less than 15 days, complication of other diseases, invasive operations, and use of multiple antibiotics were the risk factors for the nosocomial infections in the patients with pulmonary tuberculosis （P〈0. 05）. CONCLUSION The advanced age, long length of hospital stay, use of multiple antibiotics, complication of other diseases, and invasive operations are the risk factors for the nosocomial infections in the patients with pulmonary tuberculosis, and it is necessary to take targeted prevention countermeasures to reduce the incidence of nosocomial infections.