多重耐药菌医院感染的病原学特点与风险因素分析及信息化精准管理模式应用效果

Etiological characteristics and risk factors analysis of multiple drug resistant bacteria hospital infection and application effect of accurate information-based management mode

目的 研究多重耐药菌医院感染的病原学特点与风险因素分析及信息化精准管理模式应用效果。方法 选择2020—2021年本院的住院患者共611例作为研究对象,其中2020年住院患者300例(2020年组),2021年住院患者311例(2021年组)。2020年组发生多重耐药菌医院感染患者45例,2021年组发生多重耐药菌医院感染患者11例,并进一步按是否发生感染,将所有患者分为感染组(66例)和非感染组(545例)。分别对各分组患者的多重耐药菌医院感染的病原学特点、医院感染发生的单因素以及多因素分析,各分组医护人员的医院感染知晓情况、督导得分情况以及医院感染控制的医护人员的专业知识水平进行分析。结果 2020年组以及2021年组多重耐药菌医院感染情况比较,差异无统计学意义(P>0.05),但是2021年组的医院感染发生率低于2020年组,感染组以及未感染组患者的年龄、糖尿病、COPD、吸烟、心功能分级、住院天数以及血浆白蛋白水平比较,差异存在统计学意义(P<0.05);通过logistics多因素分析,较高的年龄、心功能分级、住院天数,合并糖尿病、COPD、吸烟、以及较低血浆白蛋白水平均是造成患者医院感染发生的独立危险因素;2021年组医护人员的手卫生依从率、正确率以及手消毒剂床日消耗量高于2020年组(P<0.05);2021年组医护人员的督导得分高于2020年组(P<0.05);2021年组医护人员的基础知识、职业暴露预防与处置、手卫生、消毒灭菌、医疗废物管理、微生物送检、多重耐药菌防控、传染病管理得分显著高于2020年组,差异存在统计学意义(P<0.05)。结论 较高的年龄、心功能分级、住院天数,合并糖尿病、COPD、吸烟、以及较低血浆白蛋白水平均是造成患者医院感染发生的独立危险因素,采用信息化精准管理模式干预,有效降低患者发生多重耐药菌医院感染的发生风险。

Objective To study the etiological characteristics of hospital infection with multiple drug resistant bacteria and analyse the risk factors and explore the application effect of accurate information management mode.Methods In this study,611 patients hospitalized in our hospital during 2020 and 2021 were selected as the research objects.The 300 hospitalized patients those were admitted to the hospital in 2020 were enrolled in the 2020 group,and the 311paitients those were admitted to the hospital in 2021 were enrolled in the 2021 group.There were 45 hospitalized patients with multidrug resistant bacteria nosocomial infection in 2020 and there were 11 in 2021.According to the infection conditions they were divided into infection group(66) and non-infection group(545).The etiological characteristics of multidrug resistant bacteria nosocomial infection in patients,single-factor and multi-factor analysis of nosocomial infection occurrence,nosocomial infection awareness and supervision score among medical staff in the two groups and professional knowledge level of medical staff in nosocomial infection control were analyzed respectively.Results There was no statistically significant difference in hospital infection of multidrug-resistant bacteria between group 2020 and 2021(P>0.05),but the incidence of hospital infection in group 2021 was significantly lower than that in group 2020.There were statistically significant differences in age,diabetes,COPD,smoking,heart function grade,length of stay and plasma albumin level between the infected group and the uninfected group(P<0.05).According to logistics multi-factor analysis,higher age,heart function grade,length of stay,diabetes,COPD,smoking and low plasma albumin level are all independent risk factors for nosocomial infection in patients.The compliance rate and accuracy rate of hand hygiene and daily consumption of hand disinfectant(per bed) among medical staff in group 2021 were significantly higher than those in group 2020(P<0.05).The supervision score of medical staff in group 2021 was significantly higher than that in group 2021(P<0.05).The scores of basic knowledge,occupational exposure prevention and treatment,hand hygiene,disinfection and sterilization,medical waste management,microbial testing,multi-drug resistant bacteria prevention and control,and infectious disease management of medical staff in group 2021 were significantly higher than those in group 2020,with statistical significance(P<0.05).Conclusions Higher age,heart function grade,length of stay,complicated with diabetes,COPD,smoking,and low plasma albumin level are all independent risk factors for nosocomial infection among patients.The intervention of information-based precise management mode could effectively reduce the risk of multi-drug resistant nosocomial infection in patients.