摘要
目的分析老年肾功能衰竭患者血液透析相关感染的病原菌分布和影响因素,为医院感染预防和控制工作提供客观依据。方法选取2016年2月-2017年2月行血液透析治疗的175例老年肾功能衰竭患者作为研究对象,分析患者医院感染情况,采集感染患者临床标本进行病原菌培养与鉴定,对影响医院感染的相关因素进行单因素及多因素非条件Logistic回归分析。结果 175例老年肾功能衰竭患者中有99例患者发生医院感染,感染率为56.57%,共发生感染114次,以呼吸道感染和尿路感染为主,分别占42.98%和28.95%,铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、肺炎链球菌、白假丝酵母为主要病原菌;多因素Logistic回归分析结果显示,年龄、透析时间、血肌酐(sCr)水平、合并糖尿病是老年肾衰竭血液透析患者发生医院感染的独立影响因素。结论老年肾功能衰竭血液透析患者医院感染的病原菌分布和相关因素具有一定的特征性,临床医师应给予密切的监控和合理的干预,从而降低医院感染率、提高医院感染预防和控制效果。
OBJECTIVE To investigate the distribution of pathogens causing hemodialysis-related infections in elderly patients with renal failure and analyze the influencing factors so as to provide objective basis for prevention and control of nosocomial infections.METHODS A total of 175 elderly patients with renal failure who received hemodialysis from Feb 2016 to Feb 2017 were recruited as the study objects,the incidence of nosocomial infections in the patients was analyzed,the clinical specimens were collected from the patients with the infection so as to conduct the culture of pathogens,and univariate analysis and non-conditional multivariate logistic regression analysis were performed for the influencing factors for the nosocomial infections.RESULTS Of the 175 elderly patients with renal failure,99 had nosocomial infections,with the infection rate 56.57%;totally 114 case-times of patients had infections,the patients with respiratory tract infections accounted for 42.98%,and the patients with urinary tract infections accounted for 28.95%.Pseudomonasaeruginosa,Klebsiella pneumoniae,Staphylococcus aureus,Streptococcus pneumoniae and Candida albicans were the major species of pathogens.The result of the multivariate logistic regression analysis indicated that the age,hemodialysis time,serum creatinine（sCr）level and complication with diabetes mellitus were the independent influencing factors for the nosocomial infections in the elderly patients with renal failure.CONCLUSION The distribution of pathogens and related factors for nosocomial infections show certain characteristics in the elderly renal failure patients undergoing the hemodialysis.It is necessary for clinicians to attach great importance to the monitoring and take reasonable interventions so as to reduce the incidence of nosocomial infections and improve the effect of prevention and control of the nosocomial infections.
作者
吴丽英
陈文
WU Li-ying;CHEN Wen(The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570102, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第9期1367-1370,共4页
Chinese Journal of Nosocomiology
基金
海南省科技厅基金资助项目(ZDXM2015085)
关键词
老年
肾功能衰竭
血液透析
医院感染
病原菌分布
The elderly
Renal failure
Hemodialysis
Nosocomial infection
Distribution of pathogen
