导管相关性尿路感染危险因素分析及干预效果研究

Catheter associated urinary tract infection risk factors analysis and intervention study

[目的]调查某三级甲等医院导管相关性尿路感染(CAUTI)现况,分析危险因素并干预,为有效控制CAUTI提供依据。[方法]对某三级甲等医院2014年4月—2014年12月557例留置导尿病人进行目标性监测,分析CAUTI现况及危险因素并于2015年1月开始干预,对比干预前后感染率,评价干预效果。[结果]单因素分析显示有住院时间、入住重症监护室(ICU)时间、留置尿管时间、24h尿量、合并糖尿病、大便失禁6个变量与CAUTI明显相关,多因素分析筛选出独立危险因素,依次为留置尿管时间≥20d、大便失禁、糖尿病、入住ICU时间≥20d,保护因素为24h尿量≥3 000mL;干预前感染率35.37%,干预后20.44%,差异有统计学意义(P<0.05)。[结论]该三级甲等医院CAUTI发生率较高,危险因素较多,采取针对性干预措施可有效控制CAUTI。

Objective:To investigate the current status of catheter associated urinary tract infection(CAUTI)in a hospital,analyze the risk factors and provide scientific evidence for the effective control of CAUTI.Methods:557patients with indwelling urethral catheterization in a hospital in April 2014 to December were targeted monitoring,the status and risk factors of CAUTI were analyzed,and intervention measures were begun to implement in January 2015.The infection rate before and after the intervention was compared and the effectiveness of intervention was evaluated.Results:Univariate analysis showed that there were six variables of CAUTI risk factors.Logistic regression analysis was used to screen the independent risk factor as followed:indwelling catheter time≥20days,fecal incontinence,diabetes,ICU length of stay≥20days,and protective factors is the 24 hours urine volume≥3 000 mL.The infection rate were 35.37% and 20.44% before and after the intervention,the difference was statistically significant(P<0.05).Conclusion:There is a higher incidence of CAUTI and more risk factors in the hospital.Take targeted intervention measures can effectively control CAUTI.