摘要
目的分析呼吸系统疾病住院患者医院感染的相关影响因素及防治策略。方法收集玉溪市某医院2013年1月1日至2017年12月31日因呼吸系统疾病住院的患者医院感染的临床资料,描述感染病原菌分布,利用跨栏负二项分布回归模型分析病原菌种类丰盛度影响因素。结果217例医院感染者中,112例为多重病原菌感染(51.61%,95%CI:44.96%~58.26%)。检出407株病原菌,以假丝酵母菌属、奈瑟菌、草绿色链球菌为主。多元跨栏负二项分布回归显示:有侵入性操作的发生多重病原菌感染的概率增加2.318倍,病原菌感染种类增加1.511倍;使用特殊类抗菌药物的发生多重病原菌感染的概率增加3.058倍,病原菌感染种类增加1.499倍;相对于未使用联合抗菌药物组,联合抗菌药物使用时间≥7 d的发生多重病原菌感染的概率增加3.367倍,病原菌感染种类增加1.839倍;降钙素原异常的发生多重病原菌感染的概率增加15.975倍,病原菌感染种类增加2.054倍。结论感染病原菌种类及分布特点与侵入性操作、特殊类抗菌药物的使用、联合抗菌药物使用时间及降钙素原异常等因素相关。对其采取针对性的防治策略,可减少院内感染的发生。
Objective To analyze the influencing factors of nosocomial infection in patients with respiratory diseases and the prevention and treatment strategies.Methods The clinical data related to nosocomial infection among patients with respiratory system disease in People's Hospital of Yuxi City were collected between January 1,2013 and December 31,2017and the pathogens distributions were described,the influencing factors of abundance of pathogens were analyzed using hurdle negative binomial distribution regression model.Results Among 217 patients with nosocomial infection,there were 112 cases with multiple infections(51.61%,95%CI:44.96%~58.26%).407 strains of pathogens were isolated and had a higher proportion of infections in Candida,Neisseria and Viridans streptococcus.The hurdle negative binomial distribution regression model showed that patients who had the invasive operations and used special antibiotics before had the combined antimicrobial therapy more than 7 days。And with the abnormal procalcitonin,they were more likely to be multiplely infected and the pathogen abundance increased by 2.318 and 1.511 times,3.058 and 1.499 times,15.975 and 2.054 times respectively.Conclusion The types and distribution of pathogenic bacteria are related to the invasive operation, the use of special antibiotics, the use time of combined antibiotics,and the abnormality of procalcitonin. The incidence of nosocomial infection can be reduced by adopting specific prevention and treatment strategies.
作者
周云春
董文斌
李世福
陈黎跃
张继华
ZHOU Yun-chun;DONG Wen-bin;LI Shi-fu;CHEN Li-yue;ZHANG Ji-hua(Dept.of Pulmonary and Critical Care Medicine,People's Hospital of Yuxi City,Yuxi Yunnan 653100;Division of STDs&AIDS Control,Yuxi Centre for Disease Control and Prevention,Yuxi Yunnan 653100,China)
出处
《昆明医科大学学报》
CAS
2020年第9期86-92,共7页
Journal of Kunming Medical University
基金
云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(201801CH00535)。
关键词
呼吸系统疾病
医院感染
病原菌
影响因素
Respiratory system disease
Nosocomial infection
Pathogens
Influence factors
