骨科住院患者医院感染现状及危险因素调查分析

The status quo of nosocomial infection and the risk factors contributing to nosocomial infection: a retrospective survey

目的了解骨科住院患者医院感染现状及危险因素,为防治骨科住院患者医院感染提供参考依据。方法回顾性调查分析6897例骨科住院患者病历资料。结果 6897例骨科住院患者,290例发生医院感染,感染率为4.20%;感染部位前5位依次为上呼吸道(27.59%)、泌尿道(25.17%)、手术部位(23.79%)、皮肤软组织(10.69%)、下呼吸道(5.52%);感染菌株前5位依次为大肠埃希菌(21.43%)、金黄色葡萄球菌(19.05%)、铜绿假单胞菌(18.45%)、鲍曼不动杆菌(8.93%)、肺炎克雷伯菌(8.33%)。不同年龄、基础疾病、住院时间、手术时间、手术类别、侵入性操作、抗生素使用的患者间医院感染率不同,差异有统计学意义(P<0.01)。结论骨科住院患者存在一定的医院感染率,可能与患者年龄>60岁、基础疾病、住院时间、手术时间、手术类别、侵入性操作、抗生素的使用等因素有关。

Objective To understand the status quo of nosocomial infection and the risk factors that contribute to the disease so as to obtain scientific knowledge for the prevention and treatment of nosocomial infection occurring in the department of orthopedics.Method Firstly,the inpatients from the department of orthopedics were taken as the subjects of study.A retrospective survey was then conducted to analyze the medical records of6897inpatients in the department of orthopedics.Findings Of the6897inpatients in the department of orthopedics,290was found to have nosocomial infection.The infection rate was4.20%.The top5sites of infection were upper respiratory tract(27.59%),urinary tract(25.17%),operative site(23.79%),skin and soft tissue(10.69%),and lower respiratory tract(5.52%).The top5infected strains were Escherichia coli(21.43%),Staphylococcus aureus(19.05%),Pseudomonas aeruginosa(18.45%),Bauman Acinetobacter(8.93%)and Klebsiella pneumoniae(8.33%).A patient’s age,basic diseases,time of hospitalization,operation time,operation category,invasive operation,and antibiotic were found to be variables causing difference in rate of infection among the patients.The differences were statistically significant(P<0.01).Conclusion Infection occurs in the inpatients of the department of orthopedics in a hospital.The patients’age(≥60years),basic diseases,hospitalization time,operation time,operation type,invasive operation,use of antibiotics can be risk factors that contribute to the disease.