摘要
目的研究脑梗死患者发生医院感染的相关因素及病原菌分布状况。方法对2013年1月—2016年12月1216例脑梗死患者的临床资料进行回顾性分析。分析脑梗死患者发生医院感染及病原菌分布情况。应用多因素Logistic回归分析脑梗死患者发生医院感染的危险因素。结果本组共发生医院感染99例,感染发生率为8.14%;主要感染部位为下呼吸道41例(41.41%)和泌尿道25例(25.25%)。年龄≥70岁、手术、吸烟、中心静脉插管、留置尿管、留置胃管、使用呼吸机、气管插管、意识障碍、脑出血、慢性阻塞性肺疾病史、住院时间≥30 d是脑梗死患者发生医院感染的独立危险因素(P<0.05)。共检测出121株病原菌,其中革兰阳性菌69株(57.02%)、革兰阴性菌48株(39.67%)、真菌4株(3.31%)。结论脑梗死患者医院感染发生率高、影响因素多、病原菌分布广泛,临床治疗过程中应根据患者具体情况采取合理防治措施,降低医院感染发生率,改善患者预后。
Objective To investigate related factors and distribution of pathogenic bacteria of nosocomial infection in patients with cerebral infarction. Methods Clinical data of 1216 patients with cerebral infarction admitted during January 2013 and December 2016 was retrospectively analyzed. Nosocomial infection and distribution of pathogenic bacteria in patients with cerebral infarction were analyzed. Multivariate logistic regression was used to analyze risk factors of nosocomial infection in patients with cerebral infarction. Results There were 99 patients with nosocomial infection in this group, and incidence rate of nosocomial infection was 8.14%. Main sites of infection were 41 patients (41.41%) with lower respiratory tract and 25 patients (25.25%) with urinary tract. Age equal or more than 70 years old, operation, smoking, central venous catheterization, indwelling urinary catheter, indwelling gastric tube, ventilator use, tracheal intubation, disturbance of consciousness, cerebral hemorrhage, history of chronic obstructive pulmonary disease and hospitalization time equal or more than 30 d were independent risk factors for nosocomial infection in patients with cerebral infarction ( P <0.05). A total of 121 pathogenic bacteria were detected, in which there were 69 (57.02%) Gram-positive bacteria, 48 (39.67%) Gram-negative bacteria and 4 (3.31%) fungi. Conclusion Incidence rate of nosocomial infection in patients with cerebral infarction is high with many influencing factors and wide distribution of pathogenic bacteria. In the course of clinical treatment, reasonable prevention and control measures should be taken according to specific conditions of patients in order to reduce incidence rate of nosocomial infection and improve prognosis of patients.
作者
何芳
张自艳
HE Fang;ZHANG Zi-yan(Department of Respiratory Medicine, Central Hospital of Xiangyang, Xiangyang, Hubei 441000, China)
出处
《解放军医药杂志》
CAS
2019年第3期104-107,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
湖北省科技厅资助项目(2012DGA11009)
关键词
脑梗死
医院感染
危险因素
细菌
Brain infarction
Nosocomial infection
Risk factors
Bacteria
