某院住院烧伤患者医院获得性肺炎病原菌分布特点及影响因素研究

Distribution characteristics and influencing factors of nosocomial pneumonia in burn department

目的研究住院烧伤患者医院获得性肺炎的危险因素及其病原学特点。方法采用回顾性调查和病原菌分离鉴定方法,对某医院住院烧伤患者医院获得性肺炎的发生情况及痰培养结果进行分析与评价。结果共调查该医院住院烧伤患者598例,有78例罹患医院获得性肺炎,感染发生率为13.04%。从78例患者的痰标本中分离出病原菌85株,其中革兰阳性菌、革兰阴性菌及真菌构成比依次为14.12%、77.64%和8.24%。多因素分析结果显示,患者高龄、重度烧伤、合并低蛋白血症、合并吸入性损伤、气管插管及ICU停留时间等构成住院烧伤患者医院获得性肺炎的危险因素(OR>1,P<0.05)。结论住院烧伤患者医院获得性肺炎的发生率较高,病原菌以革兰阴性菌为主,发病与多种因素关系密切。

Objective To determine the risk factors of nosocomial pneumonia in burn patients and the pathogenic characteristics of sputum culture.Methods The retrospective analysis method and The burn patients in our hospital were selected to collect and count the incidence of hospital acquired pneumonia and sputum culture results.The related factors that may lead to hospital acquired pneumonia in burn department were analyzed statistically.Results Among 598 burn patients,78 had hospital acquired pneumonia,the incidence of which was 13.04%.There were 85 strains of pathogenic bacteria in the sputum of 78 patients with hospital acquired pneumonia.Among them,12 strains(14.12%),66 strains(77.64%)and 7 strains(8.24%)were Gram-positive bacteria,Gram-negative bacteria and fungi,respectively.The results of logistic analysis showed that age≥65 years old,severe burn,hypoalbuminemia,inhalation injury,tracheotomy or intubation,and ICU stay time≥7 days were the risk factors of hospital acquired pneumonia in burn patients(OR>1,P<0.05).Conclusion The incidence of nosocomial acquired pneumonia in burn patients is high.Gram-negative bacteria are the main bacteria in sputum culture,which are closely related to many factors.