保定地区髋部骨折患者院内感染情况及危险因素分析

Analysis of nosocomial infection and its risk factors in patients with hip fracture in Baoding region

目的探讨分析髋部骨折患者院内感染发生情况以及其危险因素。方法选择2020年1月至2023年1月保定市3家综合性医院的骨科住院手术治疗的髋部骨折患者为研究对象,收集患者疾病相关信息,并对其院内感染情况进行跟踪随访,采集疑似感染者生物样本用于病原菌培养及鉴定,采用描述分析法分析院内感染发生情况,并采用单、多因素分析方法对院内感染的危险因素进行分析。结果本研究共纳入1012例患者,发生院内感染87例,院内感染发生率为8.60%,其中泌尿系统感染42例,肺部感染26例,手术切口感染10例,其他感染9例。87例院内感染患者的样本中培养出病原菌98株,其中革兰阳性菌30株(30.61%),革兰阴性菌67株(68.37%),真菌1株(1.02%)。多因素logistic回归分析结果显示年龄(OR=1.581)、基础疾病(OR=1.442)、手术时间(OR=1.689)、术后卧床时间(OR=1.730)、术后住院时间(OR=1.530)、侵入性操作(OR=1.659)、术中异体输血(OR=1.436)、季节(OR=1.637)是髋部骨折患者院内感染的危险因素。结论髋部骨折患者的院内感染发生率较高,且病原菌主要为革兰阴性菌,年龄、基础疾病、手术时间、术后卧床时间、术后住院时间、侵入性操作、术中异体输血、季节是髋部骨折患者院内感染的危险因素。

Objective To investigate the incidence of nosocomial infection and its risk factors in patients with hip fracture.Methods Patients with hip fracture undergoing in-patient surgery in three general hospitals in Baoding City from January 2020 to January 2023 were selected for this study.Disease-related information was collected and nosocomial infections were followed up.Biological samples of suspected infected patients were collected for pathogen culture and iden‐tification,and the incidence of nosocomial infections was analyzed by descriptive analysis.The risk factors of nosocomial in‐fection were analyzed by univariate and multivariate analysis methods.Results A total of 1012 patients were enrolled in this study,among whom 87 developed nosocomial infections(8.60%).These infections included 42 cases of urinary system infection,26 cases of pulmonary infection,10 cases of surgical incision infection,and 9 cases of other infections.Among the patients with nosocomial infections,a total of 98 strains of pathogenic bacteria were cultured:30 gram-positive bacte‐ria(30.61%),67 gram-negative bacteria(68.37%),and one fungus(1.02%).Multivariate logistic regression analysis re‐vealed that age(OR=1.581),underlying disease(OR=1.442),duration of surgery(OR=1.689),postoperative bed time(OR=1.730),postoperative hospital stay(OR=1.530),invasive procedures(OR=1.659),intraoperative allogeneic blood transfusion(OR=1.436),and seasonality factors(OR=1.637)were identified as risk factors for nosocomial infections in patients with hip fracture.Conclusions The incidence of nosocomial infection in patients with hip fracture is significantly high,predominantly attributed to gram-negative bacteria.Age,underlying disease,duration of surgery,postoperative bed time,postoperative hospital stay,invasive procedures,intraoperative allogeneic blood transfusion,and seasonality fac‐tors are identified as risk factors for nosocomial infection in patients with hip fracture.