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目的探索肾病科医院感染的相关危险因素及病原菌分布,为控制感染提供依据。方法对2010年1月-2014年6月肾病科11 389例患者的临床资料进行回顾性调查,应用单因素分析和多因素logistic回归分析对感染危险因素进行分析,采用SPSS17.0软件对数据进行统计分析。结果肾病科11 389例患者发生医院感染344例、391例次,感染率3.02%、例次感染率3.43%;感染部位以下呼吸道感染为主,占43.99%;共检出病原菌309株,革兰阴性菌136株占44.02%,革兰阳性菌84株占27.18%,真菌89株占28.80%;单因素分析显示,体质量较低、介入史、年龄偏高、高血压、糖尿病、尿毒症、慢性肾功能不全、肾病综合征、总住院天数、入住ICU、中心静脉置管、使用呼吸机及留置尿管等与医院感染的发生存在密切的相关性(P<0.05);多因素logistic回归分析结果显示,体质量较低、入住ICU、住院时间长、患有高血压、肾病综合征、使用呼吸机、中心静脉置管及留置尿管是医院感染发生的独立危险因素(P<0.05)。结论在临床工作中,针对危险因素采取相应控制措施,以预防与控制医院感染的发生。
Objective To explore the risk factors and pathogens distribution of nosocomial infection in nephrology so as to provide basis for controlling infection. Methods The clinical data of 11 389 patients with nephrology from January 2010 to June 2014 were retrospectively analyzed. Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors of infection. Data were analyzed using SPSS17.0 software Statistical Analysis. Results In the nephrology department, 11 389 patients were hospitalized with 344 cases and 391 cases with infection rate of 3.02% and infection rate of 3.43% respectively. The main respiratory tract infection was 43.99% 136 strains of negative bacteria accounted for 44.02%, 84 strains of gram-positive bacteria accounted for 27.18%, 89 strains of fungi accounted for 28.80%; univariate analysis showed that low body mass, history of intervention, high age, hypertension, diabetes, uremia, Chronic renal insufficiency, nephrotic syndrome, total hospital stay, ICU admission, central venous catheterization, use of ventilator and indwelling catheter were closely related to the occurrence of nosocomial infections (P <0.05). Multivariate logistic regression analysis The results showed that lower body mass, hospital stay, long hospital stay, hypertension, nephrotic syndrome, ventilator, central venous catheter and indwelling catheter were the independent risk factors of nosocomial infection (P <0.05). Conclusion In the clinical work, we take corresponding control measures for risk factors to prevent and control the occurrence of nosocomial infections.