泌尿外科住院患者医院感染危险因素分析

Risk factors of nosocomial infections in patients of urinary surgical department

目的研究泌尿外科医院感染的相关危险因素及主要病原菌分布,为临床控制医院感染提供依据。方法对2010年1月-2014年11月泌尿外科7 648例患者资料进行回顾性调查,应用单因素χ2、多因素回归分析统计方法进行统计分析。结果共有84例患者发生医院感染,感染率为1.10%,感染94例次,例次感染率1.22%;其中主要的感染部位为泌尿道、菌血症和下呼吸道,分别占22.34%、19.15%和14.89%;检出病原菌94株,以大肠埃希菌、屎肠球菌、肺炎克雷伯菌、阴沟肠杆菌和鲍氏不动杆菌为主,共61株,其中多药耐药菌31株,检出率为50.82%;接受外科手术、年龄偏大、患有膀胱癌和住院时间长是发生医院感染的危险因素(P<0.05)。结论对含有以上危险因素高危患者应高度关注,积极采取预防与控制措施,防止感染的发生。

OBJECTIVE To explore the risk factors of nosocomial infections in the urinary surgical department so as to provide references for taking infection control measures .METHODS A retrospective survey was conducted on the nosocomial infections in 7652 patients in the urinary surgical department from Jan .2010 to Dec .2014 .The risk factors were analyzed by single factor χ^2 test and multivariate regression analysis .RESULTS The nosocomial infections occurred in 84（94 case‐times） patients with the incidence rate of 1 .10% and the case‐time infection rate of 1 .22% ,among which the main infection sites were urinary tract accounting for 22 .34% ,bloodstream 19 .15% , and lower respiratory tract 14 .89% . A total of 94 strains of pathogens were isolated . The most common pathogens （totally 61 strains） were Escherichia coli ,Enterococcus f aecium ,K lebsiella pneumoniae ,Enterobacter cloacae and A cinetobacter baumannii ,including 31 strains of multidrug‐resistant bacteria （50 .82% ） .Surgery ,old age ,bladder cancer ,long time of hospitalization were the risk factors for incidence of nosocomial infections in these patients （P〈 0 .05） .CONCLUSION In daily clinical work ,more attention should be paid to the high‐risk patients and active prevention and control measures should be taken to prevent the onset of nosocomial infections .