心血管内科住院患者医院感染高危因素分析

Risk factors for healthcare-associated infection in patients in department of cardiology

目的探讨心血管内科住院患者医院感染的危险因素。方法采用回顾性病例对照研究分析心血管内科患者的临床资料,将发生医院感染的患者作为病例组,未发生医院感染的患者作为对照组,比较两组患者在可能引起医院感染的因素变量上的差异。结果 2 308例患者发生医院感染117例,感染率为5.07%。感染部位以呼吸道为主(71例次,占60.68%);共分离病原菌90株,革兰阴性菌65株(占72.22%),革兰阳性菌20株(占22.22%),真菌5株(占5.56%)。单因素检验7个变量是影响医院感染的危险因素,经多因素非条件logistic回归分析,影响心血管内科的医院感染独立危险因素为年龄、心功能分级、血浆清蛋白水平、侵入性操作。结论心血管内科患者医院感染率较高,与多种因素有关。应对高龄、住院时间长患者密切关注,及时纠正心力衰竭,积极治疗合并症,尽量减少侵入性操作,严格无菌操作规程。

Objective To evaluate the risk factors for healthcare-associated infection（HAI）in patients in department of cardiology.Methods Clinical data of inpatients were performed retrospective case-control analysis,patients with HAI were as case group,while without HAI were as control group,factors for HAI between two groups were compared.Results 117 cases of HAI occurred among 2 308 patients,infection rate was 5.07%.The main infection site was respiratory tract（n=71,60.68%）;a total of 90 pathogenic isolates were isolated,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 72.22%（n=65）,22.22%（n=20）,and 5.56%（n=5）respectively.Univariate analysis revealed that 7 variables were risk factors for HAI,multivariate non-conditional logistic regression analysis revealed that independent risk factors for HAI were age,cardiac function classification,serum albumin level,and invasive operation.Conclusion HAI rate is higher among cardiology inpatients,which is related to many factors.Attention should be paid to the elderly,long term hospitalization,heart failure correcting,treatment for complications,reducing of invasive procedure,and strict sterile manipulation.