感染科患者医院感染危险因素分析及预防策略

Analysis of Risk Factors and Prevention Strategies of Nosocomial Infection in Patients in Infection Department

目的调查感染科患者院内感染的发生情况,分析院内感染的危险因素,探讨院内感染的防控措施。方法对2017年1月至2017年12月在我院感染科住院的患者进行院内感染监测,收集患者的基本信息、临床资料和院内感染情况。结果本次调查共收集1251例病例,发生院内感染18例,院内感染率为1.44%,感染部位以下呼吸道感染为主,其次是血液系统、腹腔内组织感染。18例院内感染患者共培养分离病原菌18株,其中革兰阴性菌13株(72.22%),革兰阳性菌4株(22.22%),真菌1株(5.56%)。单因素分析显示,年龄、血清白蛋白、WBC、肝硬化、使用广谱抗菌药物、侵入性操作及住院天数是感染科住院患者院内感染的影响因素(p<0.05)。多因素Logistic回归分析结果显示,年龄、血清白蛋白、WBC、使用广谱抗菌药物及住院天数是感染科住院患者院内感染的独立危险因素(p<0.05)。结论年龄、血清白蛋白、WBC、使用广谱抗菌药物及住院天数是感染科住院患者院内感染的高危因素,对其采取有针对性的防控措施,以减少院内感染的发生。

Objective To investigate the incidence rate of nosocomial infection and its risk factors,and to explore the prevention and control countermeasures of nosocomial infection in the Infectious disease department.Methods The nosocomial infection was monitored in patients who admitted our hospital in the infectious disease department from January 2017 to December 2017.The basic information,clinical data and nosocomial infection of the patients were collected.Results A total of 1251 patients were enrolled in the present study.Among them,18 cases of nosocomial infection occurred,and the incidence rate of nosocomial infection was 1.44%.The most commonly seen sites of nosocomial infection were lower respiratory tract,blood system,and abdominal cavity.A total of 18 strains of isolated pathogens were cultured in 18 patients with nosocomial infection,of which 13 strains(72.22%)were gram-negative bacteria,4 strains were gram-positive bacteria(22.22%)and 1 strain was fungi(5.56%).Univariate analysis showed that age,serum albumin,WBC,liver cirrhosis,use of broad-spectrum antibiotics,invasive operations and numbers of hospitalization day were influencing factors of nosocomial infection(p<0.05).Multi-variate logistic regression analysis showed age,serum albumin,WBC,use of broad-spectrum antibiotics and numbers of hospitalization day were independent influencing factors of nosocomial infection(p<0.05).Conclusion Age,serum albumin,WBC,use of broad-spectrum antibiotics and numbers of hospitalization day were risk factors of nosocomial infection for inpatients of the infectious disease department.Targeted prevention and control countermeasures should be taken to reduce the incidence of nosocomial infection.