眼科住院患者医院感染情况及相关危险因素

The survey and related risk factors of ophthalmology inpatient hospital infection

目的探讨眼科住院患者医院感染发生情况及危险因素,并提出预防控制措施。方法2013年1月至2014年12月选取828例眼科住院患者为研究对象,根据患者是否发生医院感染分为感染组（52例）及非感染组（776例）,采用单因素及Logistic多因素分析筛选眼科住院患者医院感染的相关危险因素。结果眼科住院患者医院感染发生率为6.28%（52/828）,感染部位主要为切口感染3.38%（28/828）。经单因素分析显示,年龄〉60岁、夏季住院、手术时间、住院时间≥14 d、多人病房、侵入性操作、接触性检查、术前未应用抗菌药物、合并糖尿病、Ⅱ类切口及操作者资料〈3年与眼科住院患者术后感染有关。经Logistic多因素分析显示,患者年龄〉60岁（OR=2.995,95%CI：1.406~6.383）、住院时间≥14 d（OR=3.102,95%CI：1.267~7.597）、合并糖尿病（OR=3.494,95%CI：1.948~6.266）、术前未应用抗菌药物（OR=4.768,95%CI：2.233~10.181）、侵入性操作（OR=5.652,95%CI：2.197~14.537）以及接触性检查（OR=6.135,95%CI：2.919~12.895）是眼科住院患者医院感染的独立危险因素。结论眼科住院患者医院感染发生率较高,临床应严格规范无菌操作,加强对老年、合并糖尿病等高危人群管理,术前科学合理应用抗菌药物,尽量缩短患者住院时间有助于降低眼科住院患者医院感染的发生率。

Objective To investigate the survey and related risk factors of hospital infection of ophthalmology inpatient. Methods Total of 828 cases of ophthalmology inpatients were divided into infected group （52 cases） and non-infected group （776 cases） from January 2013 to December 2014. The screening risk factors associated with ophthalmic hospital infections in hospitalized patients were analyzed with univariate and multivariate Logistic analysis. Results The ophthalmology inpatient hospital infection rate was 6.28% （52/828）, the main site of infection was wound infection 3.38% （28/828）. The age 〉 60 years old, summer hospitalization, surgery time, hospital stay ≥14 d, multiplayer ward, invasive procedures, contact examination, preoperative antibiotics, diabetes, Ⅱ type incision and operator information 〈 3 years were related with ophthalmology hospital infections with univariate analysis. The age 〉 60 years old （OR = 2.995, 95%CI： 1.406-6.383）, hospital stay 〉/ 14 d （OR = 3.102, 95%CI： 1.267-7.597）, diabetes （OR = 3.494, 95%CI： 1.948-6.266）, preoperative antibiotics （OR = 4.768, 95%CI： 2.233-10.181）, invasive procedures （OR = 5.652, 95%CI： 2.197-14.537） and contact inspection （OR = 6.135, 95%CI： 2.919-12.895） were the independent risk factors for ophthalmology hospital infections in hospitalized patients with Logistic regression. Conclusions The ophthalmology hospital infections in hospitalized patients had a higher incidence, which should be strictly strengthed for elderly hi＇gh-risk groups, such as diabetes management, scientific and rational use of antibiotics before surgery to shorten the hospital stay, which would help reduce ophthalmology inpatient hospital infections.