摘要
目的探讨留置深静脉导管后医院感染病原菌监测及危险因素分析,为医院感染防治提供参考。方法回顾性分析2011年6月-2014年12月行深静脉穿刺置管术的400例患者临床资料,调查医院感染率及感染病原菌分布,采用非条件多因素logistic回归分析导致医院感染率的独立危险因素。结果 400例深静脉留置导管患者共有44例发生医院感染,感染率11.0%;共分离出79株病原菌,其中革兰阳性菌51株占64.6%,革兰阴性菌22株占27.8%,真菌6株占7.6%;单因素分析显示,年龄>60岁、导管留置时间>7d、住院时间>2周、卧床时间>14d、广谱抗菌药使用时间>7d、合并基础疾病、使用免疫抑制剂患者感染率显著上升(P<0.05);多因素分析显示,年龄>60岁、导管留置时间>7d、广谱抗菌药使用、合并基础疾病是导致深静脉导管留置后医院感染的独立危险因素。结论留置深静脉导管后医院感染病原菌主要是革兰阳性菌;临床上需要针对危险因素制定相应预防措施,以降低医院感染发生率。
OBJECTIVE To explore the pathogens causing nosocomial infections after the deep venous catheter indwelling and analyze the risk factors so as to provide guidance for prevention and treatment of nosocomial infections.METHODS The clinical data of 400 patients who underwent the deep venous puncture catheterization from Jun 2011 to Dec 2014 were retrospectively analyzed,the incidence of nosocomial infections and distribution of pathogens were investigated,and the non-conditional multivariate logistic regression analysis was performed for the independent risk factors for the nosocomial infections.RESULTS The nosocomial infections occurred in 44of400 patients with deep venous catheter indwelling,with the infection rate of 11.0%.A total of 79 strains of pathogens have been isolated,including 51（64.6%）strains of gram-positive bacteria,22（27.8%）strains of gram-negative bacteria,and 6（7.6%）strains of fungi.The univariate analysis indicated that the infection rate was increasingly high in the patients with more than 60 years old,catheter indwelling time more than 7days,length of hospital stay more than 2weeks,bedridden time more than 14 days,time of use of broad spectrum antibiotics more than 7days,complication of underlying disease,and use of immunosuppressants（P〈0.05）.The multivariate analysis showed that the age,catheter indwelling time,use of broad spectrum antibiotics,and complication of underlying diseases were the independent risk factor for the nosocomial infections after the deep venous catheter indwelling.CONCLUSIONThe gram-positive bacteria are the predominant pathogens causing the nosocomial infections after the deep venous catheter indwelling.It is necessary for the hospital to formulate corresponding prevention measures aiming at the risk factors so as to reduce the incidence of the nosocomial infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第14期3235-3237,共3页
Chinese Journal of Nosocomiology
基金
山东省自然科学基金资助项目(Y2006C02)
关键词
深静脉导管
留置
医院感染
病原菌
危险因素
Deep venous catheter
Indwelling
Nosocomial infection
Pathogen
Risk factor
