介入手术患者医院感染特征及相关因素分析

Characteristics and related factors for nosocomial infections in patients undergoing interventional procedures

  • 摘要: 目的 探讨介入手术患者术后医院感染临床特点及其相关因素,为控制介入手术感染提供依据。方法 采用前瞻性队列研究方法,选择某三级甲等医院介入科2017年1-12月行介入手术的患者为研究对象,分析患者术后医院感染发生率、感染部位及感染病原菌分布,采用单因素χ2检验、多因素logistic回归进行相关因素分析。结果 共监测介入手术住院患者1308例,术后发生医院感染63例、65例次,医院感染发生率为4.82%、例次感染率为4.97%; 感染部位主要为腹(盆)腔,下呼吸道, 导管相关,其中以腹(盆)腔感染率最高,占47.69%; 63例患者共检出病原菌31株,其中革兰阳性菌14株(45.16%),革兰阴性菌16株(51.61%),真菌1株(3.23%)。单因素分析显示恶性肿瘤、手术次数、手术类型、术后保留导管是介入手术患者发生医院感染的相关因素,多因素Logistic回归结果显示,术后保留导管、手术类型、恶性肿瘤是其独立相关因素。结论 介入手术患者术后医院感染有一定的发生率且影响因素较多,应对介入手术患者加强监测,针对感染风险因素采取综合防控措施,以期预防感染发生。

     

    Abstract: OBJECTIVE To explore the clinical characteristics and related factors for postoperative nosocomial infections in patients undergoing interventional procedures so as to provide guidance for control of the infections due to the interventional procedures. METHODS By means of prospective cohort study, the patients who received interventional procedures in intervention department of a three-A hospital from Jan 2017 to Dec 2017 were recruited as the study objects.The incidence of postoperative nosocomial infections, infection sites and pathogens causing the infections were observed, and the univariate chi-square test and multivariate logistic regression analysis were performed. RESULTS Of totally 1308 hospitalized patients who received the interventional procedures, 63 (65 case-times) patients had postoperative nosocomial infections, with the infection rate 4.82%, the case-time infection rate 4.97%.The abdominal (pelvic) cavity, lower respiratory tract and catheter indwelling site were the major infection sites; the patients with abdominal (pelvic) infection were dominant, accounting for 47.69%.Totally 31 strains of pathogens were isolated from the 63 patients, 14 (45.16%) of which were gram-positive bacteria, 16 (51.61%) were gram-negative bacteria, and 1 (3.23%) was fungus.The univariate analysis showed that malignant tumor, number of times of surgery, types of surgery and postoperative catheter indwelling were the related factors for the nosocomial infections.The multivariate logistic regression analysis indicated that the postoperative catheter indwelling, types of surgery and malignant tumor were the independent related factors for the infections. CONCLUSION There are a variety of influencing factors for the postoperative nosocomial infection in the patients undergoing the interventional procedures.It is necessary to strengthen the monitoring of the patients and take targeted and comprehensive prevention measures so as to prevent the infections.

     

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