摘要
目的探讨60岁以上老年精神疾病患者院内感染的病原菌分布特征以及院内感染的影响因素。方法对1 806例精神病患者予以回顾法分析,按照住院期发生院内感染与否,将1 806例患者分为感染组(88例)与非感染组(1 718例),观察分析精神病患者的院内感染发生率、病原菌分布情况,同时采用单因素以及多因素分析法筛选院内感染的相关危险因素。结果 1 806例精神病患者中,院内感染发生率为4.87%(88/1 806),主要感染部位为泌尿系统和呼吸道。88例感染者中,分离培养出8种病原菌,共16株,阳性检出率为18.18%(16/88),其中革兰氏阳性杆菌4株,占25.00%;革兰氏阴性杆菌12株,占75.00%,其中以沙门菌志贺菌感染为常见。非条件logistic多因素分析结果显示,药物不良反应(OR=5.233,P=0.025)、合并基础性疾病(OR=4.406,P=0.031)、侵袭操作(OR=5.590,P=0.030)是精神病患者院内感染的主要危险因素。结论革兰氏阴性杆菌是老年精神病患者院内感染的主要病原菌,院内感染发生率较高,多发于泌尿系统与呼吸道。针对相关危险因素,提高护理人员素质及技能,加强基础性疾病的预防与治疗,减少药物副反应,继而减少院内感染发生。
Objective To investigate the pathogenic bacteria distribution and the influencing factors of nosocomial infection in patients with mental illness over 60 years old.Methods Review method was used to analyze 1 806 psychiatric patients, and according to the period of nosocomial infection, the infection of 1 806 patients were divided into the infection group(88 cases) and the non-infection group(1 718 cases). The incidence of nosocomial infection and pathogen distribution of psychotic patients were observed and analyzed, and at the same time single factor and multiple factors were used to screen related risk factors for nosocomial infection.Results Among the 1 806 psychiatric patients, the incidence of nosocomial infection was 4.87%(88/1 806), and the main infection site was urinary tract infection and respiratory tract infection. Among the 88 infected patients, 8 pathogenic bacteria were isolated and cultured, with 16 strains, and the positive detection rate was 18.18%(16/88), among which 4 strains of gram-positive bacillus accounted for 25.00%. 12 strains of gram-negative bacillus accounted for 75.00%, and shigella infection was common. Through unconditioned Logistic multi-factor analysis, adverse drug reactions(OR=5.233, P=0.025), combined basic diseases(OR=4.406, P=0.031) and invasive operations(OR=5.590, P=0.030) were the main risk factors for nosocomial infection in patients with mental illness.Conclusion Gram negative bacteria are the main pathogenic bacteria in nosocomial infection of elderly psychiatric patients with a greater incidence of nosocomial infection, mainly in the urinary tract and respiratory tract. According to related risk factors, we should improve the quality and skills of nursing staff, strengthen the prevention and treatment of underlying diseases, reduce drug adverse reactions, and then reduce the nosocomial infection occurrence.
作者
叶晓洁
季显琼
Ye Xiaojie;Ji Xianqiong(Department of Infection Management,Seventh People's Hospital,Wenzhou 325000,China)
出处
《中国医院统计》
2019年第1期50-53,共4页
Chinese Journal of Hospital Statistics
关键词
精神病
老年
病原菌
危险因素
干预措施
mental illness
old age
pathogenic bacteria
risk factor
intervention
