某医院2015—2017年老年呼吸系统疾病患者院内感染统计及危险因素分析

Statistics and risk factors of nosocomial infection in elderly patients with respiratory diseases in recent three years

目的分析浙江医院近3年老年呼吸系统疾病患者发生院内感染情况,探讨感染危险因素,为预防院内感染提供参考。方法回顾性分析2015年1月至2017年6月期间浙江医院分院收治的4 233例老年(≥60岁)呼吸系统疾病患者临床资料,将发生院内感染的452例患者纳入研究组,其余患者纳入对照组。采用单因素分析和logistic回归模型分析院内感染发生的危险因素。结果 452例院内感染者送检标本中,共检出572株微生物,其中革兰氏阳性菌189株(33.05%)、革兰氏阴性菌347株(60.66%)、真菌36株(6.29%)。单一病原菌感染患者394例(87.17%),混合感染患者58例(12.83%)。感染分布最多的3个部位为呼吸道(56.19%)、泌尿生殖道(21.24%)和血液(13.05%)。Logistic分析结果显示年龄≥70岁(OR=1.804,95%CI:1.478～2.197)、合并糖尿病(OR=1.908,95%CI:1.557～2.338)、长期卧床(OR=1.639,95%CI:1.281～2.097)、住院时间≥2周(OR=1.405,95%CI:1.153～1.713)、侵入性操作(OR=1. 954,95%CI:1.579～2.419)是老年呼吸系统疾病患者发生院内感染的危险因素。结论年龄≥70岁、合并糖尿病、长期卧床、住院时间≥2周、侵入性操作的老年呼吸系统疾病患者,应作为重点防控对象。

Objective To analyze the incidence of nosocomial infection of the elderly patients with respiratory diseases in the last three years in Zhejiang Hospital,and to explore the risk factors of infection,and to provide reference for the prevention of nosocomial infection.Methods The clinical data of 4233 cases of elderly patients with respiratory system diseases in Zhejiang Hospital from January 2015 to June 2017 was analyzed retrospectively,with 452 cases of nosocomial infection in the study group and the rest in the control group.Single factor analysis and Logistic regression model were used to analyze the risk factors of nosocomial infection.452 patients with nosocomial infection were included in the study group,and the remaining patients were included in the control group.Single factor analysis and Logistic regression model were used to analyze the risk factors of nosocomial infection.Results A total of 572 microorganisms was detected in 452 cases of nosocomial infection,including gram positive bacteria 189(33.05%),gram negative bacteria 347(60.66%),and fungi 36(6.29%).And 394 patients(87.17%)were infected with single pathogens,and 58(12.83%)patients were with mixed infection.The three most widely distributed sites were respiratory tract(56.19%),urogenital tract(21.24%),and blood(13.05%).Logistic analysis showed that the age of 70 years old and above(OR=1.804,95%CI:1.478~2.197),diabetes mellitus(OR=1.908,95%CI:1.557~2.338),bedridden(OR=1.639,95%CI:1.281~2.097),hospitalization time 2 weeks and above(OR=1.405,95%CI:1.153~1.713),and invasive procedures(OR=1.954,95%CI:1.579~2.419)were risk factors of nosocomial infection in elderly patients with respiratory diseases.Conclusion Patients with senile respiratory diseases aged 70 years or above,with diabetes mellitus,bedridden,hospitalization time 2 weeks and above,and invasive operation should be the focus of prevention and control.