摘要
目的探讨重症患者导管相关性尿路感染(catheter-associated urinary tract infections,CAUTI)的危险因素,为临床制订预防措施提供依据。方法选取2014-2017年海口市第三人民医院收治的1 026例重症患者,根据其是否发生CAUTI分为CAUTI组(61例)和非CAUTI组(965例)。应用单因素分析及多元逐步Logistic回归分析重症患者CAUTI的相关危险因素。结果 1 026例重症患者CAUTI的发生率为5.95%(61/1 026),千日感染率为4.93%(61/12 379)。61例CAUTI共分离病原菌71株,其中革兰阴性菌占43.66%(31/71),真菌占30.99%(22/71),革兰阳性菌占25.35%(18/71)。Logistic回归分析显示,插管时间[OR=3.142(95%CI:2.316~4.108)]、侵入性操作[OR=1.629(95%CI:1.163~2.108)]、留置导尿管时间[OR=2.618(95%CI:1.985~3.228)]及昏迷时间[OR=1.705(95%CI:1.214~2.206)]是重症患者导管相关性尿路感染的独立危险因素。结论插管时间、侵入性操作、留置导尿管时间及昏迷时间是重症患者导管相关性尿路感染的独立危险因素,应针对该类患者制订相应措施,以降低CAUTI的发病率。
Objective To explore the risk factors of catheter-related urinary tract infection （catheter-associated urinary tract infections, CAUTI） in critically ill patients, and provide evidences for the development of preventive measures. Methods One thousand and twenty-six critically ill patients in the Third People＇s Hospital of Haikou were selected and divided into CAUTI group （n=61） and non CAUTI group （n=965） according to whether they had CAUTI. Univariate analysis and multiple stepwise logistic regression were used to analyze the risk factors associated with CAUTI in severe patients. Results The incidence of CAUTI in 1 026 severe patients was 5.95% （61/1 026）, and the rate of 1 000 day infection was 4.93% （61/12 379）. A total of 71 strains of pathogens were isolated from 61 cases with CAUTI, including gram negtive bacteria （43.66%）, fungi （30.99%） and gram positive bacteria （25.35%）. Univariate and multivariate logistic regression analysis showed that the duration of mechanical ventilation [OR, 3.142 （95% CI, 2.316-4.108）], invasive operation [OR, 1.629 （95% CI, 1.163-2.108）], duration of catheterization [OR, 2.618 （95% CI, 1.985-3.228）] and duration of coma [OR, 1.705 （95% CI, 1.214-2.206）] were independent risk factors of critically ill patients with catheter-associated urinary tract infections. Conclusion Duration of mechanical ventilation, invasive operation, duration of catheterization and duration of coma are independent risk factors of catheter-associated urinary tract infection in critically ill patients, and corresponding measures should be taken to reduce the incidence of CAUTI.
作者
郑奋薇
蔡桂程
梁美莲
陈曼君
陈冬花
ZHENG Fenwei;CAI Guicheng;LIANG Meilian;CHEN Manjun;CHEN Donghua(Department of Urology, Third People＇s Hospital of Haikou, Haikou 571100, Hainan Province, China)
出处
《解放军医学院学报》
CAS
2018年第6期494-497,共4页
Academic Journal of Chinese PLA Medical School
基金
海南省医药卫生科研基金项目(16A51602)~~
关键词
重症患者
导管相关性尿路感染
危险因素
severe patients
catheter-associated urinary tract infection
risk factors
