2018—2019年某医院老年2型糖尿病并发医院感染患者病原菌分布及危险因素分析

Pathogen distribution and risk factors analysis on elderly patients combining type 2 diabetes associated nosocomial infection from 2018 to 2019

目的分析老年2型糖尿病并发医院感染患者的病原菌分布及危险因素。方法采用回顾性调查方法,对内蒙古地区某三甲医院2018年1月—2019年12月老年2型糖尿病住院患者是否发生医院感染进行分析,通过单因素分析、多因素Logistic分析筛选出老年2型糖尿病患者医院感染发生的独立危险因素。结果老年2型糖尿病患者共2032例,其中发生医院感染345例,占比16.97%;345例医院感染患者共培养菌株437株,其中革兰阴性菌占比为63.38%,革兰阳性菌占比21.97%,真菌占比14.65%;从单因素分析与多因素Logistic回归分析结果看,使用抗菌药物>2种、住院天数>14 d、有创性操作、血糖指数>8(HbAlc)、糖尿病并发症是导致老年2型糖尿病患者发生革兰阴性菌医院感染的独立危险因素。结论老年2型糖尿病患者医院感染发生率较高,使用抗菌药物、住院天数、有创性操作、血糖指数、糖尿病并发症等是独立危险因素。

Objective To analyze pathogen distribution and risk factors of elderly patients combining type 2 diabetes and healthcare associated infection.Methods Retrospective research was used to analyze whether type 2 diabetes elderly patients of a tertiary hospital during January 2018 to December 2019 had healthcare associated infection.Single factor analysis and multi-factor Logistic analysis were used to screen independent risk factors of type 2 diabetes elderly patients having healthcare associated infection.Results Total 2032 type 2 diabetes elderly patients were investigated,345 patients had healthcare associated infection which constituted 16.97%of all patients.Total 437 strains of bacteria were found from 348 patients,63.38%were gram negative bacteria,21.97%were gram positive bacteria,14.65%were fungus.From result of single factor analysis and multi-factor Logistic analysis,antibiotic types used>2,length of stay>14 d,invasive operation,glycemic index>8(HbAlc),diabetes combining were independent risk factors of type 2 diabetes elderly patients had gram negative bacteria related healthcare associated infection.Conclusion Type 2 diabetes elderly patients have high incidence rate of healthcare associated infection,and antibiotics use,length of stay,invasive operation,glycemic index,diabetes combining are independent risk factors.