冠心病合并心力衰竭患者医院感染病原学特点及影响因素

Etiological characteristics and influencing factors for nosocomial infection in coronary heart disease patients complicated with heart failure

目的探究冠心病合并心衰患者医院感染的影响因素及病原学特点。方法选择海口市第三人民医院2010年6月-2017年12月收治的312例冠心病合并心衰患者作为研究对象,回顾性分析患者临床资料,观察医院感染发生情况,单因素及多因素Logistic回归分析冠心病合并心衰患者发生医院感染影响因素。结果 312例冠心病合并心衰患者中有30例患者发生医院感染,感染率为9.62%,其中以呼吸系统感染为主,其次为泌尿道感染、消化道感染。30例医院感染患者经分泌物或者血培养共检出病原菌54株,其中革兰阴性菌29株占53.70%。患者年龄≥60岁、合并糖尿病、COPD、发生过误吸、有侵入性操作、住院时间≥1周、长期卧床、有吸烟史是导致冠心病合并心衰患者发生医院感染的影响因素(P<0.05)。结论了解冠心病合并心衰患者发生医院感染的临床特点、病原学特点,针对医院感染的影响因素给予合理的干预措施,有利于降低医院感染率。

OBJECTIVE To explore the etiological characteristics and influencing factors for nosocomial infection in coronary heart disease patients complicated with heart failure.METHODS A total of 312 coronary heart disease patients who were complicated with heart failure and treated in Haikou Third People′s Hospital from Jun 2010 to Dec 2017 were recruited as the study objects,the clinical data of the patients were retrospectively analyzed,the incidence of nosocomial infection was observed,and the univariate analysis and multivariate logistic regression analysis were performed for the influencing factors for the nosocomial infection in the coronary heart disease patients complicated with heart failure.RESULTS Of the 312 coronary heart disease patients complicated with heart failure,30 had nosocomial infection,with the infection rate 9.62%;the patients who had respiratory system infection were dominant,followed by the patients with urinary tract infection and the patients with gastrointestinal tract infection.Totally 54 strains of pathogens were isolated from secretions or blood specimens of the 30 patients with nosocomial infection,29(53.70%)of which were gram-negative bacteria.No less than 60 years of age,complication with diabetes mellitus,COPD,aspiration,invasive operation,length of hospital stay no less than 1 week,long bed-ridden time and smoking history were the influencing factors for the nosocomial infection in the coronary heart disease patients complicated with heart failure(P<0.05).CONCLUSION It is an effective way to understand the clinical and etiological characteristics of nosocomial infection in the coronary heart disease patients complicated with heart failure and take reasonable intervention measures according to the influencing factors so as to reduce the incidence of nosocomial infection.