摘要
目的分析医院感染患者类型构成比、病原菌分布,并找出可能导致感染的相关危险因素,以便指导临床工作达到降低医院感染发生。方法选取2018年9月1日-2020年1月31日某院重症监护室发生医院感染患者196例,统计发生医院感染患者类型构成比,分析重症监护室患者感染病原菌分布情况,对重症监护室感染患者临床资料进行单因素分析,并对可能导致感染医院感染的影响因素进行多因素Logistic回归分析。结果感染196例患者中,共检出215例致病菌,革兰阴性菌和革兰阳性菌所占比为65.58%和22.33%;分别以大肠埃希菌和金黄色葡萄球菌最为常见,所占比为26.05%和9.77%;真菌均为白色假丝酵母菌,占12.09%。经过χ^(2)检验,年龄≥60岁、使用机械通气、住院时间≥14天、合并糖尿病、抗菌药物应用、抗菌药物种类≥3种、侵入性操作等因素为重症监护室患者发生感染的影响因素与未发生感染组相比差异有统计学意义P<0.05。经过Logistic分析,年龄≥60岁、使用机械通气、住院时间≥14天、合并糖尿病、抗菌药物应用、抗菌药物种类≥3种、侵入性操作等因素均为可能导致重症监护室患者发生医院感染的独立危险因素,差异有统计学意义P<0.05。结论重症监护室发生医院感染病原菌以大肠埃希菌为主的革兰阴性菌最为常见,应重视年龄偏大、住院时间较长、合并糖尿病、抗生素使用、有侵入性操作患者,根据患者个性化特点,采取适当的护理措施进行干预,降低重症监护室发生医院感染风险。
Objectives To analyze the composition ratio of nosocomial infection patients and the distribution of pathogenic bacteria,and find out the risk factors that may cause nosocomial infection,so as to guide the clinical work to reduce the occurrence of nosocomial infection.Methods From September 1st,2018 to January 31st,2020,196 cases of patients with hospital infection occurred in a hospital intensive care unit were selected statistics of hospital infection in patients with type composition ratio,analysis of the distribution of the intensive care unit patients infected with pathogenic bacteria,Univariate analysis was performed on the clinical data of patients with ICU infection,and multivariate Logistic regression analysis was performed on the influencing factors that might lead to nosocomial infection.Results A total of 215 cases of pathogenic bacteria were detected in 196 patients,and the proportion of Gram-negative bacteria and Gram-positive bacteria were 65.58%and 22.33%.Escherichia coli and Staphylococcus aureus were the most common,accounting for 26.05%and 9.77%,respectively.All the fungi were Candida albicans,accounting for 12.09%.Chi-χ^(2) test showed that age≥60 years old,use of mechanical ventilation,hospitalization time≥14 days,diabetes mellitus,application of antimicrobial drugs,types of antimicrobial drugs≥3,invasive operation and other factors were the influencing factors of infection in ICU patients compared with the non-infection group,with statistical significance(P<0.05).Logistic analysis showed that age≥60 years old,use of mechanical ventilation,length of hospital stay≥14 days,combined diabetes,application of antibiotics,≥3 types of antibiotics,invasive procedures and other factors were all independent risk factors for hospital infection in ICU patients,with statistical significance P<0.05.Conclusions ICU hospital infection pathogens to E.coli mainly Gram-negative bacteria were the most common,should attach importance to the older,the length of time was longer,diabetes mellitus,antibiotics,patients with invasive operation,according to patients with personalized characteristic,take appropriate nursing intervention,reduce the ICU hospital infection risk.
作者
吕丽婷
张雪静
杨娜
Lv Liting;Zhang Xuejing;Yang Na(Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100102,China;不详)
出处
《中国病案》
2021年第7期110-112,共3页
Chinese Medical Record
关键词
重症监护室
医院感染
病原菌分布
危险因素
Intensive care unit
Hospital infection
Distribution of pathogenic bacteria
Risk factors
