摘要
目的探讨急性脑卒中患者医院感染的临床特点及相关危险因素,为临床控制医院感染提供依据。方法选取医院2014年6月-2015年6月收治的急性脑卒中患者340例进行研究,筛选出发生医院感染的患者,统计医院感染发生率,分析感染部位,病原菌分布及相关影响因素。结果 340例急性脑卒中患者发生医院感染58例,感染率为17.06%;其中肺部感染31例占9.12%,尿路感染13例占3.82%,消化道感染9例占2.65%,其他部位感染5例占1.47%;共分离出69株病原菌,其中革兰阴性菌47株占68.12%,革兰阳性菌7株占10.14%,真菌15株占21.74%,年龄、意识障碍、球麻痹、侵入性操作、机械通气、糖尿病、肌力3级以下、预防性应用抗菌药物及住院时间长是急性脑卒中患者发生医院感染的影响因素;多因素Logistic回归分析显示,意识障碍、机械通气、肌力3级以下、预防性应用抗菌药物及住院时间长是其发生医院感染的独立危险因素。结论急性脑卒中患者的医院感染发生率高,应加强脑血管病的一级和二级预防,减少卒中风险,积极治疗原发病,控制相关危险因素,从而减少医院感染的发生。
OBJECTIVE To study the clinical characteristics of hospital infections in patients with acute stroke and the relevant risk factors,so as to provide evidence for better control of hospital infections.METHODS A total of340 patients with acute stroke from Jun.2014 to Jun.2015 in our hospital were selected.Screened patients with nosocomial infections,from whom the hospital infection rates were recorded,and the sites of infections,pathogen distribution and related factors were analyzed.RESULTS From the 340 cases of nosocomial infections in acute stroke patients,58 cases with nosocomial infections,the rate was 17.06%,among which 31 cases of pulmonary infection,accounting for 9.12%,urinary tract infections 13cases(3.82%),gastrointestinal infections 9cases(2.65%),and other parts 5cases(1.47%).A total of 69 pathogens were isolated,including gram-negative bacteria 47 strains,accounting for 68.12%,gram-positive bacteria 7strains,accounting for 10.14%,and fungi 15 strains,accounting for 21.74%.Age,unconsciousness,palsy,invasive procedures,mechanical ventilation,diabetes,muscle three or less,prophylactic antibiotics and hospitalization for a long time were the factors of hospital infections in patients with acute stroke;multivariate logistic regression analysis showed that consciousness,mechanical ventilation,muscle strength 3or less,prevention of the use of antibiotics and hospitalization for a long time were the independent risk factors for hospital infections.CONCLUSION Acute stroke patients have high incidence of nosocomial infections,which should be strengthened primary and secondary prevention of cerebrovascular disease,reduce the risk of stroke,give aggressive treatment for primary disease,control related risk factors,so as to reduce hospital infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第14期3211-3212,3227,共3页
Chinese Journal of Nosocomiology
基金
河南科技攻关基金资助项目(112102310090)
关键词
急性脑卒中
医院感染
临床特点
相关因素
Acute stroke
Hospital infection
Clinical characteristics
Related factors