重型病毒性肝炎患者医院感染的临床危险因素分析

Clinical risk factors for nosocomial infections in patients with severe viral hepatitis

目的探讨重型病毒性肝炎患者医院感染患者的临床危险因素,制定临床预防措施,为临床治疗提供依据。方法调查分析2013年8月-2015年3月医院收治的176例重型病毒性肝炎患者临床资料,分析患者感染病原菌类型和影响患者医院感染的危险因素;采用SPSS 13.0软件进行统计分析。结果 176例患者中发生医院感染91例,感染率为51.70%;感染部位多发生于尿路、肺部、消化道,分别占41.76%、32.97%、18.68%;分离出病原菌130株,检出白色假丝酵母菌占39.23%、铜绿假单胞菌占29.23%、大肠埃希菌占26.15%及肺炎克雷伯菌占5.38%;经多因素logistic非条件回归分析得出,年龄、住院时间、有合并症、侵入性操作、预防性抗菌药物应用均为影响患者感染的危险因素(P<0.05)。结论重型病毒性肝炎患者年龄>60岁、住院时间过长、有合并症、有侵入性操作、未预防应用抗菌药物可增加其感染率,应有效控制临床危险因素降低患者感染发生。

OBJECTIVE To explore the clinical risk factors for nosocomial infections in patients with severe viral hepatitis and put forward the clinical intervention measures so as to provide guidance for clinical treatment.METHODS The clinical data of 176 patients with severe viral hepatitis who were treated in hospitals from Aug2013 to Mar 2015 were investigated,then the species of pathogens causing the infections and the risk factors for the nosocomial infections were observed,and the statistical analysis was performed with the use of SPSS13.0software.RESULTS Of the 176 patients,91had the nosocomial infections,with the infection rate of 51.70%;the urinary tract,lung,and gastrointestinal tract were the common infection sites,accounting for 41.76%,32.97%,and 18.68%,respectively.Totally 130 strains of pathogens were isolated,of which 39.23% were Candida albicans,29.23% were Pseudomonas aeruginosa,26.15% were Escherichia coli,and 5.38% were Klebsiella pneumoniae.The non-conditional multivariate logistic regression analysis indicated that the risk factors for the infections included the age,length of hospital stay,complications,invasive operation,and antibiotics prophylaxis（P〈0.05）.CONCLUSIONThe more than 60 years of age,long hospitalization duration,complication,invasive operation,and without antibiotics prophylaxis may lead to the increase of the infections in the patients with severe viral hepatitis.It is necessary to effectively control the clinical risk factors so as to reduce the incidence of the infections.