风湿免疫性疾病患者医院感染易感因素分析

Analysis of predisposing factors of nosocomial infections in patients with rheumatic diseases

目的探讨风湿免疫性疾病患者医院感染易感因素。方法选取于2014年1月-2016年12月医院收治的风湿免疫性疾病患者300例为研究对象,分析医院感染发生情况,采集医院感染患者感染部位标本分离鉴定病原菌,调查患者性别、年龄、基础疾病、住院时间、侵入性操作、静脉置管、免疫抑制剂、淋巴细胞计数、预防使用抗菌药物情况,单因素和多因素Logistic回归分析医院感染的影响因素。结果 300例风湿免疫性疾病患者发生医院感染29例,医院感染率为9.67%;29例医院感染患者中,以呼吸系统感染为主,占37.93%;29例医院感染患者共分离培养病原菌43株,其中革兰阴性菌27株占62.79%、革兰阳性菌14株占32.56%、真菌2株占4.65%;多因素Logistic回归分析结果显示,风湿免疫性疾病患者医院感染影响因素为住院时间≥30d、侵入性操作、静脉置管、免疫抑制剂、淋巴细胞计数减少及未预防使用抗菌药物(P<0.05)。结论风湿免疫性疾病患者医院感染受多因素影响,为降低医院感染的发生,应根据相关影响因素采取针对性预防措施。

OBJECTIVE To investigate the predisposing factors of nosocomial infections in patients with rheumatic diseases.METHODS A total of 300 cases of rheumatic immune disease patients in our hospital from Jan.2014 to Dec.2016 were selected,and the incidence of nosocomial infections was analyzed.The pathogenic bacteria were collected and identified in the infected sites of nosocomial infected patients,and the gender,age,underlying diseases,hospitalization time,invasive operation,venous catheterization,immunosuppressant,lymphocyte count,and the prevention of use of antibiotics were investigated.The influencing factors of nosocomial infections were analyzed by univariate and multivariate logistic regression analysis.RESULTS There were 29 cases of nosocomial infections in 300 cases of rheumatic immune diseases,and the rate of nosocomial infection was 9.67%.Among the29 cases of nosocomial infections,respiratory system infection was the main infection,accounting for 37.93%.There were 43 strains of pathogenic bacteria isolated from 29 cases of nosocomial infections,including 27 strains of gram-negative bacteria accounting for 62.79%,14 strains of gram-positive bacteria accounting for 32.56%,and2 strains of fungi accounting for 4.65%,respectively.Multivariable logistic regression analysis showed that hospital stay≥30 d,invasive procedures,intravenous catheters,immunosuppressive agents,lymphocyte counts,and without antimicrobial prophylaxis were risk factors for nosocomial infections in patients with rheumatic diseases（P〈0.05）.CONCLUSIONNosocomial infection in patients with rheumatic diseases is influenced by many factors,so in order to reduce the incidence of nosocomial infections,preventive measures should be taken according to relevant factors.