急性冠脉综合征患者发生医院感染相关危险因素的病例对照研究

Case-control study on correlated risk factors of acute coronary syndrome patients with hospital infection

目的探讨急性冠脉综合征(ACS)患者发生医院感染的特征及其相关危险因素。方法选取65例发生医院感染的ACS患者作为感染组,同期随机选取130例未发生医院感染的ACS患者作为未感染组;采用病例对照的研究方法,回顾性收集可能影响ACS发生医院感染的相关危险因素;采用单因素分析和多因素分析来筛选ACS发生医院感染的高危因素。结果 ACS住院期间的感染率为13.8%(65/472),感染部位以呼吸系统和泌尿系统为主,病原菌则以革兰阴性菌为主;多因素分析显示,年龄(OR=1.900)、糖尿病(OR=3.908)、COPD(OR=4.509)、侵入性操作(OR=5.155)、心功能分级(OR=3.019)、使用抗菌药物(OR=2.442)为ACS患者发生医院感染的危险因素,而早期血运重建(OR=0.480)则为保护因素。结论 ACS患者住院期间具有较高的医院感染率,应引起医护人员的高度重视,针对这些高危因素,早期采取预防措施,降低患者的医院感染发生率。

Objective To explore the characteristics and correlated risk factors of acute coronary syndrome（ ACS） patients with hospital infection. Methods Sixty-five cases of hospital infection of ACS were selected as the infection group,and130 cases of ACS without hospital infection were randomly selected as the non-infection group. With case-control study method,the correlated risk factors were retrospectively collected,and the high risk factors were screened by single factor and multiple factor methods. Results The infection rate of ACS in hospitalization was 13.8%（ 65/472）,with infection site mainly in respiratory system and urinary system. Gram-negative bacteria were the main pathogenic bacteria. Multiple factors analysis result indicated that the risk factors of hospital infection of ACS included age（ OR = 1.900）,diabetes mellitus（ OR = 3.908）,COPD（ OR = 4.509）,Invasive operation（ OR = 5. 155）,classification of cardiac function（ OR = 3. 019） and the use of antibacteria（ OR =2. 442）,while early revascularization（ OR = 0. 480） was the protective factor. Conclusion ACS patients have a high hospital infection rate during hospitalization,so it should be paid attention to by medical and nursing staff. To aim directly at these high risk factors,we should early adopt intervention measures to cut down the incidence rate of hospital infection.