基层医院烧伤科住院患者医院感染的发生情况和病原菌的特点

Occurrence of nosocomial infection and characteristics of pathogenic bacteria in inpatients from burn department of a primary hospital

目的旨在探究基层医院住院的烧伤患者医院感染发生情况及病原菌分布特点,为实施针对性的干预提供依据。方法选取在医院烧伤科住院的患者378例为研究对象,回顾性分析患者的住院病历资料,对烧伤科住院患者医院感染发生情况、病原学特点及其危险因素等情况进行统计学分析。结果378例基层医院烧伤科住院患者中,发生医院感染的有78例,医院感染发生率为20.63%,而78例发生医院感染的患者中,共检出103株病原菌,其中革兰阳性菌42株(40.78%),革兰阴性菌58株(56.31%),真菌3株(2.91%);Logistic回归分析的结果表明,年龄≥60岁、合并基础疾病、侵入性操作、合并低蛋白血症以及住院时间≥30 d是导致基层医院烧伤科住院患者医院感染发生的危险因素(OR>1,P<0.05),而病房消毒次数≥2次/d则是避免烧伤患者医院感染发生的保护性因素(OR<1,P<0.05)。结论基层医院烧伤患者的医院感染发生率较高,虽然革兰阴性菌的检出率最高,但革兰阳性菌亦占有较大比例。患者医院感染的危险因素较多,应引起我们的重视。

Objective To investigate the incidence of nosocomial infection and the distribution of pathogens in burn patients in a primary hospital,and to provide basis for the implementation of targeted interventions.Methods 378 inpatients in burn department of hospital were selected as the research objects,and the data of their medical records were retrospectively analyzed.The incidence of nosocomial infection,the etiological characteristics and its risk factors in burn patients were analyzed statistically.Results Among the 378 inpatients in burn department of primary hospital,78 had nosocomial infection,and the incidence of nosocomial infection was 20.63%.Among the 78 patients with nosocomial infection,103 strains of pathogenic bacteria were detected,including 42 strains(40.78%)of Gram-positive bacteria,58 strains(56.31%)of Gram-negative bacteria and 3 strains(2.91%)of fungi.The results of Logistic regression analysis showed that age≥60 years old,combination with basic diseases,invasive operation,hypoproteinemia and hospitalization time≥30 days were risk factors for nosocomial infection in burn patients in primary hospital(OR>1,P<0.05),while the number of disinfection times in wards≥2 times/day was the protective factor for avoiding nosocomial infection in burn patients(OR<1,P<0.05).Conclusion The incidence of nosocomial infection in burn patients of primary hospital is high.Although the detection rate of Gram-negative bacteria is the highest,Gram-positive bacteria also accounts for a large proportion.There are many risk factors for nosocomial infection in patients,which should be paid attention to.