摘要
目的分析急性心肌梗死患者发生医院感染的部位、病原菌分布和危险因素,提出预防措施,减少医院感染。方法回顾性分析医院2012年6月-2014年12月收治的816例急性心肌梗死并发医院感染的患者临床资料,调查其医院感染率、感染部位、病原菌分布,并对其危险因素进行单因素分析。结果 816例患者发生医院感染93例,医院感染率为11.4%,感染部位依次为:下呼吸道38例、泌尿道22例、消化道17例、上呼吸道9例及皮肤及黏膜7例,分别占40.9%、23.6%、18.3%、9.7%及7.5%;感染病原菌以革兰阴性菌为主,占73.5%,其次为革兰阳性菌占23.5%和真菌占3.0%;急性心肌梗死患者医院感染与患者的年龄、住院时间、合并糖尿病、心功能Ⅲ和Ⅳ分级、介入手术、气管插管和呼吸机使用等因素相关(P<0.05)。结论急性心肌梗死患者医院感染率较高,医院感染以呼吸道感染为主,大多数感染由革兰阴性菌引起,感染相关因素较多,临床应加强感染监测,并制定合理干预措施,减少医院感染发生。
OBJECTIVE To investigate the nosocomial infection sites of the patients with acute myocardial infarction and observe the distribution of pathogens and risk factors so as to put forward the prevention measures and reduce the incidence of nosocomial infections .METHODS The clinical data of 816 patients with acute myocardial infarction who were treated in the hospital from Jun 2012 to Dec 2014 were retrospectively analyzed ,the incidence of nosoco‐mial infections ,infection sites ,and distribution of pathogens were investigated ,and the univariate analysis was performed to observe the risk factors .RESULTS Of 816 patients ,93 had nosocomial infections with the infection rate of 11 .4% ,of whom 40 .9% had lower respiratory tract infections ,23 .6% had urinary tract infections , 18 .3% had gastrointestinal tract infections ,9 .7% had upper respiratory tract infections ,and 7 .5% had skin and mucosa infections .Among the pathogens causing the nosocomial infections ,the gram‐negative bacteria accounted for 73 .5% ,followed by the gram‐positive bacteria （23 .5% ） and the fungi （3 .0% ） .The incidence of nosocomial infections in the patients with acute myocardial infarction was associated with the age ,length of hospital stay , complication of diabetic mellitus ,grade Ⅲ and Ⅳ cardiac function ,interventional surgery ,endotracheal intuba‐tion ,and use of ventilator （P〈0 .05） .CONCLUSION The incidence of nosocomial infections is high in the patients with acute myocardial infarction ,the respiratory tract is the predominant infection site ,and the gram‐negative bac‐teria are dominant among the pathogens causing the nosocomial infections .There are a variety of related factors for the infections ,thus it is necessary for the hospital to strengthen the monitoring of infections and put forward rea‐sonable intervention measures so as to reduce the incidence of nosocomial infections .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第22期5175-5177,共3页
Chinese Journal of Nosocomiology
基金
秦皇岛市科技基金资助项目(2012023A189)
关键词
急性心肌梗死
医院感染
病原菌
危险因素
Acute myocardial infarction
Nosocomial infection
Pathogen
Risk factor
