老年痴呆患者医院感染危险因素及病原菌分布

Risk factors and pathogen distribution of nosocomial infection in patients with senile dementia

目的分析老年痴呆患者医院感染的危险因素、病原菌分布情况并提出预防措施。方法选取海南省人民医院收治的920例老年痴呆患者为研究对象,根据患者住院期间是否发生医院感染分为感染组及非感染组,统计患者医院感染的感染率、感染部位及细菌培养结果,对比年龄、性别、住院时间、合并基础病、生活自理能力、留置尿管、吞咽困难等因素在感染组及非感染组中的差异,探析引发老年痴呆患者医院感染的危险因素。结果 920例老年痴呆患者中发生医院感染为328例(35.7%),医院感染例次数为425例(46.2%);感染部位以下呼吸道感染(42.58%)最多;病原菌以革兰阴性菌为主(60.28%)。单因素及多因素分析表明患者年龄≥70岁、住院时间≥15 d、基础疾病≥2种、留置尿管、吞咽困难和生活自理能力需要依赖是判断医院感染的主要危险因素(P<0.05)。结论针对危险因素,可采取缩短住院时间,有效治疗基础疾病,严格无菌操作,加强护理等切实有效的预防感染措施,降低老年痴呆患者医院感染的发生。

Objective To analyze the risk factors and pathogen distribution of nosocomial infection in senile dementia patients and propose preventive measures.Methods 920 cases of senile dementia patients in our hospital treated were selected as the research objects;patients with infection during hospitalization as infection group,for those without infection as non infection group.Infection rate,infection site and bacterial culture results of patients with nosocomial infections were analyzed.The age,gender,length of hospitalization,combined basic disease,self-care ability,indwelling urinary catheter and dysphagia of infection group and non-infection group were compared.The risk factors that cause hospital infection in senile dementia patients were analyzed.Results Nosocomial infections occurred in 328(35.7%) of the 920 patients with dementia,and the number of nosocomial infections was 425 case time(46.2%).Most of the cases were lower respiratory tract infections(42.58%).The pathogenic bacteria were mainly Gram-negative bacilli(60.28%).Univariate and multivariate analysis showed that patients ≥ 70 years old,hospital stay ≥ 15 d,with basic diseases ≥ 2,indwelling urinary catheter,difficulty swallowing and self-reliance were the main risk factors for nosocomial infection(P<0.05).Conclusion In order to reduce the incidence of nosocomial infection in senile dementia patients,effective infection prevention measures such as shortening hospital stay,effective treatment of basic diseases,strict aseptic operation,and strengthening nursing should be taken.