Characteristics and risk factors of nosocomial infections in patients with chronic renal insufficiency

OBJECTIVE To investigate the characteristics and risk factors of nosocomial infections in patients with chronic renal insufficiency. METHODS A total of 893 patients with chronic renal insufficiency in our hospital from May 2015 to May 2017 were selected, and nosocomial infections occurred in 60 cases. Sputum, blood and urine specimens from patients with nosocomial infections were collected for bacterial isolation and culture, and the bacteria were identified with VITEK biological identification system of BioMerieux. Genders, age, repeated invasive procedures, plasma albumin levels, and hospital stay were statistically analyzed. RESULTS Of the 893 patients with chronic renal insufficiency, 60 cases had nosocomial infections, and the incidence of nosocomial infections was 6.72%. A total of 71 strains of pathogens were isolated from 60 cases of patients with nosocomial infections, including 41 strains of gram-negative bacteria accounting for 57.75%, 22 strains of gram-positive bacteria accounting for 30.99%, and 8 strains of fungi accounting for 11.27%. The main gram-negative bacteria had high resistant rates to cefepime and meropenem, which were all over 85%. The main gram-positive bacteria had high resistant rate to penicillin, which were all over 70%. The results of multivariable logistic regression analysis showed that, age, repeated invasive operation, plasma albumin level and hospitalization time were risk factors for nosocomial infections in patients with chronic renal insufficiency. CONCLUSION Gram-negative bacteria are the main pathogens of nosocomial infections in patients with chronic renal insufficiency. It is necessary to rationally use antibiotics according to pathogenic bacteria and drug resistance test to reduce the incidence of chronic renal insufficiency.