留置导尿患者医院感染危险因素分析

Risk factors of nosocomial infection in patients with an indwelling catheter

目的 分析留置导尿患者发生医院感染的危险因素和感染的病原菌,为降低留置导尿患者医院感染发生率提供参考。方法 选取甘肃省某三甲医院2021年1-12月发生医院感染的690例住院患者,并匹配690例未发生医院感染的住院患者,筛选有留置导尿操作的340例患者作为研究对象,采用单因素方差分析和二元Logistic回归分析发生医院感染的危险因素。结果 发生医院感染的留置导尿患者[238例(34.49%)]多于未发生医院感染的留置导尿患者[102例(14.78%)],差异具有统计学意义(χ^(2)=72.185,P<0.05)。单因素分析结果显示,放置导尿管时间、中心静脉插管时间、使用呼吸机时间、住院时间、发热时间等18个因素与留置导尿患者发生医院感染有关。多因素分析结果显示,有基础疾病、有侵入性操作(内镜)、进行器官移植、使用血液制品、操作不良事件、抗菌药物数量、住院时间为留置导尿患者医院感染的独立危险因素(P<0.05)。感染病原菌以革兰阴性菌中的鲍曼不动杆菌为主(17.30%)。结论 留置导尿患者医院感染的危险因素是多方面的,在临床实践中,医务人员应重视留置导尿患者的感染风险,针对危险因素制定并落实相应的防控措施。

Objective To analyze the risk factors and pathogenic bacteria of nosocomial infection in patients with indwelling catheterization,so as to provide reference for reducing the incidence of such infection in patients with indwelling catheterization.Methods 690 hospitalized patients with nose-acquired infection were selected from a Grade A hospital in Gansu Province from January to December 2021,and 690 hospitalized patients without nose-acquired infection were matched.340 patients with indwelling catheterization were selected as the study objects.The risk factors of nosocomial infection were analyzed by one-way ANOVA and binary Logistic regression.Results There were 238 patients(34.49%)with nosocomial infection,more than the number of original urine patients[102 cases(14.78%)],and the difference was statistically significant(χ^(2)=72.185,P<0.05).The results of single factor analysis showed that 18 factors,such as catheter placement time,central vein intubation time,ventilator use time,hospital stay time and fever time,were related to nosocomial infection in patients with indentation catheterization.The results of multivariate analysis showed that underlying disease,invasive procedure(endoscopy),organ transplantation,use of blood products,adverse operation events,number of antibiotics and length of stay were independent risk factors for nosocomial infection in patients with induration catheterization(P<0.05).The main pathogenic bacteria was Acinetobacter baumannii in gram-negative bacteria(17.30%).Conclusion Many risk factors are related to nosocomial infection in patients with indwelling catheterization.In clinical practice,medical staff should pay attention to the risks of such infection,and formulate and implement corresponding prevention and control measures.