精神科住院患者医院感染危险因素logistic回归分析

Logistic regression analysis of risk factors for nosocomial infections in hospitalized patients of psychiatric department

目的调查精神科住院患者医院感染的特点及其相关危险因素,为采取有效预防控制措施提供依据。方法采用前瞻性监测与回顾性调查相结合的方法,对精神科2007年1月-2011年12月住院患者医院感染状况进行调查,筛选危险因素,采用SPSS13.0软件进行非条件logistic回归分析。结果 1 289例精神科住院患者中发生医院感染94例、99例次,医院感染率和例次感染率分别为7.29%和7.68%;感染部位以呼吸道、胃肠道和泌尿道感染为主,分别占56.56%、16.17%、10.10%;单因素分析显示,年龄、住院天数、住院季节、精神疾病类型、合并基础疾病、住院年度、抗菌药物的使用与医院感染的发生有关(P<0.05);而logistic回归分析得出住院天数、年龄、住院年度是精神科患者发生医院感染的独立危险因素。结论根据精神科医院感染特点,调整监测方案,开展目标性监测,采取综合干预措施,可有效降低医院感染率。

OBJECTIVE To investigate the characteristics of nosocomial infections in the hospitalized patients of psychiatric department and explore the related risk factors so as to provide guidance for effective prevention and control of the infections.METHODS By means of prospective surveillance combined with retrospective survey,the prevalence of nosocomial infections in the patients who were hospitalized the psychiatric department from Jan 2007 to Dec 2011 was investigated,the risk factors were screened out,and the non-conditional logistic regression analy-sis was performed by using SPSS13.0 software.RESULTS The nosocomial infections occurred in 94 （99 case-times）of 1 289 patients who were hospitalized the psychiatric department with the incidence of nosocomial infec-tions of 7.29% and the case-time infection rate of 7.68%,among whom the patients with respiratory tract infec-tions accounted for 5 6 .5 6%,the patients with gastrointestinal tract infections 1 6 .1 7%,the patients with urinary tract infections 10.10%.The univariate analysis indicated that the age,length of hospital stay,season of hospital stay,types of mental disease,complication of underlying diseases,years of hospital stay,and use of antibiotics were associated with the incidence of the nosocomial infections （P〈0.05）;however,the logistic regression analy-sis concluded that the length of hospital stay,age,and years of hospital stay were the independent risk factors for the nosocomial infections in the patients of psychiatric department.CONCLUSION It is an effective way to adj ust the monitoring program according to the characteristics of nosocomial infections in the psychiatric department, conduct targeted monitoring,and take comprehensive intervention measures so as to reduce the incidence of noso-comial infections.