上海市闵行区社区卫生服务中心医院感染影响因素分析

Analysis of influencing factors of nosocomial infection in the community health service centers of Minhang District,Shanghai

目的:分析上海闵行区6家社区卫生服务中心住院患者医院感染病案,了解医院感染的现状及相关危险因素,为医院感染防控提供科学依据。方法:对2018年2月到2019年2月入住上海市闵行区6家社区卫生服务中心内科和舒缓疗护病房的436例住院患者进行回顾性研究,患者平均年龄(79.52±10.64)岁。其中女性251例,男性185例。分析患者的性别、年龄、诊断、合并症、病程、实验室检验指标、医院感染情况等。结果:调查的436例患者中发生医院感染155例,感染率35.55%,男性和女性的医院感染率分别为31.89%(59/185)和38.25%(96/251),差异无统计学意义(P>0.05)。医院感染好发部位以下呼吸道感染,尿路感染,上呼吸道感染最为常见,构成比分别为41.93%、23.66%、20.44%。感染者中有29例存在多部位感染,27例出现2种感染,2例存在3种感染,重叠感染占总感染例数的18.7%。有过侵袭性操作的患者医院感染率达44.11%。感染组与非感染组患者的白蛋白、空腹血糖、三酰甘油的水平以及年龄、住院天数、留置导管、罹患糖尿病或肿瘤、合并症多少的差异均有统计学意义(均P<0.05)。结论:上海闵行区社区卫生服务中心住院患者医院感染发生率高于国内平均水平。血白蛋白、空腹血糖、三酰甘油水平以及年龄、住院天数、留置导管、罹患糖尿病是患者发生医院感染的危险因素。

Objective:To understand the current situation of nosocomial infection and related risk factors through analysis of nosocomial infection records of inpatients in six community health service centers in Minhang District,so as to provide scientific basis for nosocomial infection prevention and control.Methods:A retrospective study was conducted in 436 inpatients admitted to the internal medicine department and palliative care ward of six community health service centers of Minhang District,Shanghai from February 2018 to February 2019,and the average age of the patients was(79.52±10.64)years.Among them there were 251 females and 185 males.The gender,age,diagnosis,complications,course of diseases,laboratory test indicators,and nosocomial infection of the patients were analyzed.Results:Among the 436 patients investigated,155 had nosocomial infection,the infection rate was 35.55%,the nosocomial infection rates of the males and females were 31.89%(59/185)and 38.25%(96/251),respectively,and the difference was not statistically significant(P>0.05).Nosocomial infection was prone to the low respiratory tract infection,urinary tract infection,and upper respiratory tract infection most commonly and the constituent ratio were 41.93%,23.66%,and 20.44%,respectively.Among the infected cases,29 cases had multiple site infection,27 cases had two kinds of infection,and 2 cases had three kinds of infection,and overlapping infection accounted for 18.7%of the total infections.The nosocomial infection rate of patients with invasive procedures was 44.11%.There were statistical differences between the infected group and the non-infected group in albumin,fasting blood glucose,triglyceride level,age,length of hospital stay,indwelling catheter,suffering from diabetes or tumor,and the number of complications(P<0.05).Conclusion:The incidence of nosocomial infection in the community health service centers of Minhang District is higher than that of the domestic average level.Albumin,fasting blood glucose,triglyceride,and age,length of hospital stay,indwelling catheter,and suffering from diabetes are risk factors for occurrence of nosocomial infection.