宫颈癌根治术后医院感染病原菌及影响因素分析

Pathogens causing postoperative nosocomial infections in radical hysterectomy patients and influencing factors

目的宫颈癌根治术后医院感染病原菌及影响因素分析,为宫颈癌根治术患者术后医院感染的预防提供依据。方法回顾性分析2008年1月-2016年1月医院行宫颈癌根治术的152例宫颈癌患者临床资料,调查患者术后医院感染率,并采用单因素分析及多因素Logistic回归分析探讨宫颈癌根治术术后医院感染病原菌及影响因素。结果 152例患者术后医院感染31例,感染率为20.39%;感染部位主要以泌尿道感染和手术切口感染为主,分别占32.26%、25.81%,31例医院感染患者,共检出病原菌39株,其中革兰阴性菌25株,占64.10%,革兰阳性菌11株,占28.21%,真菌3株,占7.69%;单因素分析以及多因素Logistic回归分析显示,尿管留置时间、年龄、化疗、住院时间以及糖尿病为影响宫颈癌患者术后医院感染的重要因素。结论宫颈癌根治术患者术后医院感染率较高,医院感染的相关因素较多,应引起临床工作者的重视。

OBJECTIVE To investigate the pathogens causing postoperative nosocomial infections in radical hysterectomy patients and explore the influencing factors so as to provide guidance for prevention of the postoperative nosocomial infections in the radical hysterectomy patients.METHODS The clinical data of 152 cervical cancer patients who underwent the radical hysterectomy in the hospital from Jan 2008 to Jan 2016 were retrospectively analyzed,the incidence of postoperative nosocomial infections was investigated,and univariate analysis and multivariate logistic regression analysis were performed for the pathogens and the influencing factors for the postoperative nosocomial infections in the radical hysterectomy patients.RESULTS Of the 152 patients,31 had postoperative nosocomial infections,with the infections rate 20.39%,32.26% of whom had urinary tract infection,and 25.81%had surgical incision infections.A total of 39 strains of pathogens were isolated from the 31 patients with nosocomial infection,25（64.10%）of which were gram-negative bacteria,11（28.21%）were gram-positive bacteria,and 3（7.69%）were fungi.The univariate analysis and multivariate logistic regression analysis indicated that urinary catheter indwelling time,age,chemotherapy,length of hospital stay and diabetes mellitus were the influencing factors for the postoperative nosocomial infections in the radical hysterectomy patients.CONCLUSIONThe incidence of the postoperative nosocomial infections is high in the radical hysterectomy patients;the nosocomial infection is associated with a variety of factors,which should be attached great importance by clinicians.