摘要
目的了解老年患者医院感染现患情况及影响因素,找出老年患者医院感染防控的重点问题,为进一步完善老年人群医院感染预防与控制措施提供科学依据。方法采取横断面调查的方法,床旁调查和查阅住院病历相结合,对某三级医院2017年11月23日所有住院患者进行医院感染现患率调查,采用病例对照研究方法对老年患者医院感染现状和影响因素进行分析。结果共调查老年患者1 192例,老年患者医院感染现患率为3.52%,高于非老年患者的2.24%(χ~2=4.595,P=0.032);综合ICU老年患者医院感染现患率较高为80.00%;老年患者医院感染共47例次,感染部位以下呼吸道感染29例次占61.70%为主;医院感染病原菌共检出63株,老年患者与非老年患者医院感染检出病原菌均以革兰阴性菌为主;老年患者治疗用药前送检率为33.51%,低于非老年患者的57.83%(χ~2=28.084,P<0.001);多因素Logistic回归分析结果显示,有泌尿道插管、气管插管和气管切开为老年患者医院感染的独立影响因素(P<0.05)。结论老年患者是医院感染的高危人群,应重点关注综合ICU、神经外科及康复科老年患者医院感染问题,提高病原学送检率,规范使用抗菌药物,尽量避免不必要的侵入性操作,降低老年患者医院感染发生率。
OBJECTIVE To understand the prevalence and risk factors in elderly patients with nosocomial infec- tions, and to find out the key problems of prevention and control of nosocomial infections in elderly patients, so as to provide a scientific basis for perfecting the prevention and control measures of nosocomial infections in elderly patients. METHODS Using cross-sectional survey, bedside survey and medical record reviewing method were com- bined to investigate and analyze the prevalence and risk factors of nosocomial infections of patients in a tertiary hospital on November 23, 2017. Case-control study was used to analyze the status and risk factors of nosocomial infections in elderly patients. RESULTS A total of 1192 elderly hospitalized patients were surveyed, the prevalence rate of nosocomial infections in elderly patients was 3.52 ~, which was significantly higher than that of non-elderly patients （2.24%） （X2 = 4.595, P ~ 0.032）. The most prevalence of nosocomial infection in elderly patients was comprehensive ICU, which was 80.00%. There were 47 cases of nosocomial infections in elderly patients. The main nosocomial infection site was lower respiratory tract （29 cases, 61.70~//00）. There were 63 strains of pathogen- ic bacteria of nosocomial infections were detected, and the main pathogens were gram-negative bacteria for both elderly patients and non-elderly patients. The rate of pre-treatment antibiotics use in elderly patients （33.51~） was significantly lower than that in non-elderly patients （57.83 ~） （X2 ~ 28.084, P^0.001）. Multivariable logistic regression analysis showed that urinary intubation, tracheal intubation and tracheotomy were independent risk fac- tors for nosocomial infections in elderly patients （P^0.05）. CONCLUSION Elderly patients are at high risk of nosocomial infections. We should focus on the nosocomial infections of elderly patients in comprehensive ICU, neurosurgery and rehabilitation department, improve the rate of etiological detection, standardize the use of anti-
作者
李颖
许文
戈伟
曹小琴
马黎黎
伍艳兰
王逸
范珊红
LI Ying;XU Wen;GE Wei;CAO Xiao-qin;MA Li-li;WU Yan-lan;WANG Yi;FAN Shan-hong(Tangdu Hospital, Air Force Military Medical University, Xi~an ,Shanxi 710038, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第8期1179-1182,共4页
Chinese Journal of Nosocomiology
基金
陕西省社会发展科技攻关基金资助项目(2016SF-144)
关键词
老年患者
医院感染
现患率
影响因素
抗菌药物
Elderly patients
Nosocomial infection
Prevalence rate
Risk factors
Antimicrobial agents
