神经内科住院患者医院感染危险因素分析

Risk factors for nosocomial infections in hospitalized patients of neurology department

目的了解神经内科患者医院感染发生状况,分析感染的危险因素,为探讨预防控制措施提供参考依据。方法回顾性分析2010年1月-2013年12月神经内科7 012例住院患者的临床资料,分析确诊为医院感染患者的感染率、感染部位及病原菌分布;并对医院感染的危险因素进行分析;采用SPSS11.5软件对数据进行统计分析。结果 7 012例患者发生医院感染者337例,感染率为4.8%,感染部位以下呼吸道感染为主,其次为上呼吸道感染、泌尿道、胃肠道,分别占35.9%、24.0%、17.8%、12.2%;病原菌以革兰阴性菌为主,占66.3%,其次为革兰阳性菌占28.9%;患者>60岁、男性、住院时间长、合并有基础疾病、接受侵入性治疗操作、之前使用抗菌药物和糖皮质激素易发生医院感染(P<0.01)。结论神经内科患者医院感染率高,且危险因素较多,临床中应综合预防,提高整体预防效果。

OBJECTIVE To investigate the prevalence of nosocomial infections in the patients of neurology department and analyze the risk factors for the infections so as to provide guidance for prevention and control of the infections.METHODS The clinical data of 7 012 patients who were hospitalized the neurology department from Jan 2010 to Dec 2013 were retrospectively analyzed;the infection rates,infection sites,and distribution of pathogens of the patients with confirmed nosocomial infections were observed,the risk factors for the nosocomial infections were analyzed,and the statistical analysis of data was performed with the use of SPSS11.5software.RESULTS Of 7 012 patients,337patients had the nosocomial infections with the infection rate of 4.8%,of whom 35.9% had lower respiratory tract infections,24.0% had upper respiratory tract infections,17.8% had urinary tract infections,and12.2% had gastrointestinal tract infections.The gram-negative bacteria were dominant among the pathogens,accounting for 66.3%,and the gram-positive bacteria accounted for 28.9%.The risk factors for the nosocomial infections included the more than 60 years of age,male,long length of hospital stay,complication of underlying disease,invasive operation,and history of use of antibiotics and glucocorticoids（P〈0.01）.CONCLUSIONThe incidence of the nosocomial infections is high in the patients of neurology department,and there are a variety of risk factors for the nosocomial infections.It is necessary for the hospital to take comprehensive prevention measures so as to improve the overall preventive effect.