摘要
目的了解老年骨科住院患者医院感染的发生特点,探讨老年骨科住院患者医院感染危险因素,为临床有效预防控制医院感染提供依据。方法选取2013年10月-2015年9月老年骨科住院患者4 176例,对发生医院感染的危险因素实施单因素、多因素logistic回归分析,采用Excel进行数据录入和SPSS20.0进行统计分析。结果 4 176例老年骨科住院患者中发生医院感染176例,感染率4.21%;感染部位以下呼吸道、泌尿道、骨牵引眼为主,分别占71.02%、13.64%、13.07%;医院感染发生率以第一季度最高,显著高于其他季度;共分离出病原菌142株,革兰阴性菌96株占67.61%,革兰阳性菌31株占23.81%,真菌15株占10.56%;单因素分析结果显示,性别、年龄、住院时间、手术、尿管插管次数、骨牵引、骨折、冠心病、骨质疏松症、脑萎缩及基础疾病病种数等与医院感染的发生有密切关系;多因素分析结果显示,年龄、住院时间、牵引与否、尿管插管次数、冠心病、骨质疏松是医院感染的独立危险因素。结论老年骨科住院患者医院感染以下呼吸道感染为主;病原菌以革兰阴性菌为主;医院感染的危险因素较多,医务人员应高度重视,积极治疗原发病和基础疾病,采取有针对性的医院感染防控措施,有效降低医院感染率。
OBJECTIVE To investigate the characteristics of nosocomial infections in elderly patients hospitalized in orthopedics department and explore the risk factors for the nosocomial infections in the elderly patients so as to provide guidance for effective clinical prevention and control of the nosocomial infections.METHODS A total of 4176 elderly patients who were hospitalized the orthopedics department from Oct 2013 to Sep 2015 were enrolled in the study,then the univariate,multivariate logistic regression analysis was performed for the risk factors for the nosocomial infections,and the data were entered by using Excel and statistically analyzed with the use of SPSS20.0software.RESULTS Of 4 176 elderly patients who were hospitalized in the orthopedics department,176 had the nosocomial infections with the infection rate 4.21%,of whom 71.02% had lower respiratory tract infections,13.64% had urinary tract infections,and 13.07% had skeletal traction eyes infections.The incidence of nosocomial infections was significantly higher in the first quarter than in other quarters.Totally 142 strains of pathogens were isolated,including 96（67.61%）strains of gram-negative bacteria,31（23.81%）strains of gram-positive bacteria,and 15（10.56%）strains of fungi.The univariate analysis indicated that the incidence of the nosocomial infections was closely associated with the gender,age,length of hospital stay,surgery,frequency of urinary catheterization,skeletal traction,bone fracture,coronary heart disease,osteoporosis,brain atrophy,and number of types of underlying diseases.The multivariate analysis showed that the independent risk factors for the nosocomial infections included the age,length of hospital stay,traction,frequency of urinary catheterization,coronary heart disease,and osteoporosis.CONCLUSIONThe elderly patients with lower respiratory tract infections are dominant among the elderly patients with nosocomial infections who are hospitalized in the orthopedics department.The gram-negative bacteria are the predominant pathogens.It is necessary for the health care workers to pay great attention to the risk factors for the nosocomial infections,actively treat primary diseases and underlying diseases,and take targeted prevention measures so as to effectively reduce the incidence of nosocomial infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第17期3969-3971,共3页
Chinese Journal of Nosocomiology
基金
陕西中医药大学科研创新基金项目(14XJRW-06)
陕西省科学技术研究发展计划(2013KCT-26)
关键词
老年骨科
住院患者
医院感染
危险因素
LOGISTIC回归分析
Department of orthopedics
Hospitalized patient
Nosocomial infection
Risk factor
Logistic regression analysis
