不同营养状态的老年住院患者医院感染特点

Characteristics of nosocomial infection in elderly inpatients with different nutritional status

目的:了解内分泌科不同营养状态的老年住院患者的医院感染特点,为内分泌科老年住院患者医院感染防控提供信息支持。方法:选取收治的福建省老年医院老年住院患者2948例。按照微营养评定法简表(MNS-SF)评分将患者分为正常营养组、营养不良风险组和营养不良组,比较三组患者的医院感染率、医院感染部位、医院感染的抗生素治疗途径及抗生素使用时间的差异。结果:2948例老年住院患者中,正常营养组占37.26%,营养不良风险组占41.52%,营养不良组占20.89%。三组患者的医院感染率、医院感染部位、医院感染的抗生素治疗途径及抗生素使用时间均不同,差异有统计学意义(P<0.05)。营养状况与医院感染间的Spearman相关系数r=0.262(P<0.05),与正常营养的患者比较,存在营养不良风险的患者发生医院感染的危险性升高6.11倍,存在营养不良的患者发生医院感染的危险性升高了13.85倍,差异均有统计学意义(均P<0.05)。营养状态越差,医院感染中非呼吸机相关性肺炎和非导尿管相关性尿路感染占比也越高,使用静脉或者静脉联合口服抗生素治疗医院感染的比例更高,抗生素使用时间也更长,差异均有统计学意义(均P<0.05)。结论:内分泌科老年住院患者营养不良风险率及营养不良率高,营养状态越差,医院感染率越高,医院感染的抗生素治疗时间也越长。

Objective To realize the characteristics of nosocomial infection in elderly inpatients with different nutritional status in the Department of Endocrinology,and then provide information support for the prevention and control of nosocomial infection in the elderly inpatients in the Department of Endocrinology.Method A total of 2948 elderly inpatients were collected.The patients were divided into normal nutrition group,malnutrition risk group and malnutrition group according to the mini-nutrition assessment short-form(MNS-SF).The differences in nosocomial infection rate,nosocomial infection site,nosocomial infection antibiotic treatment route and antibiotic use time were compared among the three groups.Results Among the 2948 elderly hospitalized patients,the normal nutrition group accounted for 37.255%,the malnutrition risk group accounted for 41.515%,and the malnutrition group accounted for 20.892%.The nosocomial infection rate,the nosocomial infection site,the antibiotic treatment route of nosocomial infection and the duration of antibiotic use were different among the three groups,and the difference was statistically significant(P<0.05).The Spearman correlation coefficient between nutritional status and nosocomial infection was r=0.262(P<0.05),Compared with patients with normal nutrition,the risk of nosocomial infection in patients with malnutrition risk increased by 6.111 times(P<0.05),and the risk of nosocomial infection in patients with malnutrition increased by 13.854 times(P<0.05).The worse the nutritional status,the higher the proportion of non-ventilator-associated pneumonia and non-catheter-associated urinary tract infection in nosocomial infection,and the higher proportion of using intravenous or intravenous combined oral antibiotics to treat nosocomial infection,and longer duration of antibiotic use(P<0.05).Conclusion The malnutrition risk rate and malnutrition rate of elderly inpatients in endocrinology department are high.The worse the nutritional status,the higher the nosocomial infection rate and the longer the antibiotic treatment time for nosocomial infection.