摘要
目的:探讨血液科病房患者发生院内感染的特征及影响因素。方法:选取2017年1月至2019年12月深圳市第二人民医院血液科收治的患者2658例作为研究对象,同时选取同期接受治疗但未发生院内感染的血液科患者100例作为对照组,分析患者院内感染的特征及影响因素。结果:院内感染患者中下呼吸道感染的患者最多,占35.64%;患者分离出的病原菌中最多的是大肠埃希菌,占29.63%;与对照组患者相比,院内感染患者的住院时间、侵入性操作、化疗药物的种类、淋巴细胞计数(L)、降钙素原(PCT)与C反应蛋白(CRP)等指标结果明显更高,白细胞计数(WBC)、血清白蛋白(ALB)及中性粒细胞计数(NEUT)明显更低,差异均具有统计学意义(P<0.05);多因素logistic分析结果显示,住院时间≥15 d,侵入性操作≥3次,化疗药物的种类≥3种,ALB≤30 g·L^(-1)是血液科患者发生院内感染的危险因素。结论:呼吸道感染和血液系统感染是院内感染患者中最常见的感染部位,与患者免疫能力和呼吸道的结构相关。血液科院内感染患者中大肠埃希菌、肺炎克雷伯菌是主要的致病菌。住院时间、侵入性操作、化疗药物的种类、血清ALB含量等为血液科患者发生院内感染的危险因素。
Objective To investigate the characteristics and influencing factors of nosocomial infection in hematology ward.Methods From January 2017 to December 2019,2658 patients with nosocomial infection in the Department of Hematology in the Second People’s Hospital of Shenzhen hospital were selected as the research objects,and 100 patients without nosocomial infection in the Department of Hematology in the same period were selected as the control group;Objective to collect clinical data and explore the characteristics and influencing factors of nosocomial infection.Results The lower respiratory tract infection accounted for 35.64%,followed by bacteremia(28.71%)and upper respiratory tract infection(22.77%);Escherichia coli accounted for 29.63%,followed by Klebsiella pneumoniae and Pseudomonas aeruginosa.Staphylococcus aureus and Acinetobacter baumannii were less;compared with the uninfected control group,the hospitalization days,invasive procedures,types of chemotherapy drugs,L,CRP,PCT and other indicators of patients with nosocomial infection in hematology department were significantly increased(P<0.05),while WBC,ALB and NEUT were significantly decreased(P<0.05);Multivariate logistic analysis showed that hospital stay≥15 days,invasive operation≥3 times,types of chemotherapy drugs≥3 kinds,ALB≤30 g/L were risk factors of nosocomial infection in hematology patients.Conclusion Respiratory tract infection and blood system infection are the most common infection sites in patients with nosocomial infection,which are related to the immune ability and the structure of respiratory tract.Escherichia coli and Klebsiella pneumoniae are the main pathogenic bacteria in patients with nosocomial infection in hematology department.Hospital stay,invasive operation,types of chemotherapy drugs,serum ALB content were the risk factors of blood infection.
作者
彭丽慈
杜新
PENG Li-ci;DU Xin(Guangzhou Medical University,Guangdong Guangzhou 511436;The Second People’s Hospital of Shenzhen,Guangdong Shenzhen 518035)
出处
《深圳中西医结合杂志》
2021年第11期10-13,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
院内感染
血液科
危险因素
Nosocomial infection
Hematology
Risk factors
