论文部分内容阅读
目的探讨神经内科患者医院感染发生状况和危险因素。方法回顾性分析2010~2013年神经内科住院7012例患者的临床资料,对于确诊为医院感染的患者,分析其感染分布及病原菌分类等特点。此外,通过现场问卷调查了解陪护工作人员的基本资料,分析陪护人员与医院感染发生率的关系。结果7012例患者发生医院感染者337例,感染率为4.8%,感染部位以下呼吸道感染最为常见,其次上呼吸道感染、泌尿道、胃肠道,构成比分别为35.9%、24.0%、17.8%、12.2%。病原菌分布最常见为革兰阴性菌(66.3%),其次为革兰阳性菌(28.9%),还有白色念珠菌等真菌发现。分析结果显示,60岁以上患者、男性、住院时间长、合并有基础性疾病者、接受侵入性治疗操作者、之前使用抗生素和糖皮质激素者易于发生医院感染(P<0.01)。分析陪护人员结果显示,40岁以上、女性、文化程度较高、从事陪护工作时间较长以及接受过岗前培训,陪护患者的感染率较低,但是差异均无统计学意义。结论神经内科患者医院感染发生率高,且危险因素较多,临床中应综合预防,提高整体预防效果。
Objective To investigate the occurrence and risk factors of nosocomial infections in neurology patients. Methods The clinical data of 7012 patients hospitalized in Department of Neurology from 2010 to 2013 were analyzed retrospectively. The characteristics of infection distribution and pathogen classification were analyzed in patients diagnosed as nosocomial infections. In addition, through the field survey to understand the basic information of accompanying staff, analysis of entourage and hospital infection incidence. Results Among the 7012 patients, 337 cases were hospitalized and the infection rate was 4.8%. The most common respiratory infections were below the infection site, followed by 35.9%, 24.0% and 17.8% respectively of upper respiratory tract infection, urinary tract and gastrointestinal tract, 12.2%. The most common pathogens were Gram-negative bacteria (66.3%), followed by Gram-positive bacteria (28.9%), and Candida albicans and other fungi. Analysis showed that patients over 60 years of age, hospitalized for a long period of time, with underlying diseases, and those who received invasive treatment, were more likely to develop nosocomial infections before using antibiotics and glucocorticoids (P <0.01). Analysis of accompanying staff results show that over the age of 40, women, higher education, engaged in accompanying work for a long time and received pre-job training, accompanying patients with lower infection rates, but the difference was not statistically significant. Conclusion The incidence of nosocomial infections in neurology patients is high and there are many risk factors. Therefore, comprehensive prevention should be taken in clinical practice to improve the overall preventive effect.