某院下呼吸道医院内感染患者的调查分析及对策

Investigation and analysis of infection of patients in the lower respiratory tract hospital of a hospital

目的了解某院患者下呼吸道医院内感染的状况,探讨其发生的原因。为临床治疗和防控医院内感染提供依据和对策。方法对重庆市九龙坡区人民医院2013年1—12月收治的6 425例住院患者中发生下呼吸道医院内感染189例患者的临床资料进行分析。了解下呼吸道感染与患者年龄、性别、住院时间、基础疾病、抗菌药物使用、实施侵入性操作、感染病原菌分布的关系。结果年龄小于60岁的患者感染54例(28.6%),≥60岁的患者感染135例(71.4%);感染率高的患者前3种疾病分别为:颅脑损伤及病变、慢性阻塞性肺疾病、消化系统疾病;应用高效广谱抗菌药物125例;实施侵入性操作122例;在101株感染病原菌中前3位分别为肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌。结论下呼吸道医院内感染主要与患者年龄、住院时间、基础疾病有关,特别是使用高效广谱抗菌药物、实施侵入性操作的患者更易发生。

Objective To understand the situation of infection in the lower respiratory tract hospital of a hospital,and discussed the reasons for its occurrence. Provide basis and countermeasure for clinical treatment and prevention and control of infection in hospital. Methods The clinical data of 189 patients in the lower respiratory tract hospital were analyzed in 6 425 patients admitted to the Chongqing Jiulongpo People′s Hospital from January to December 2013. To understand the relationship between respiratory tract infection and patient age,gender,hospital time,basic disease,application of antimicrobial agents,invasive operation,and distribution of pathogenic bacteria. Results Atotal of 54 cases(28.6%)of patients with age < 60 years,and 135 cases(71.4%)with patients aged 60 years or older. Patients with high infection rate had three diseases:craniocerebral injury and pathological changes,chronic obstructive pulmonary disease and digestive diseases;the application of effective broad-spectrum antimicrobial drugs in 125 cases;the invasive operation was performed in 122 cases;in the 101 strains pathogenic bacteria infection of the top three were Klebsiella pneumonia,Escherichia coli and Acinetobacter baumannii,respectively.Conclusion The lower respiratory tract cross-infection within a hospital is associated with age of the patients,hospitalization time,primary diseases,especially using efficient broad-spectrum antimicrobial agents,and the implementation of invasive operation patients are more likely to happen.