医院感染危险因素的病例对照研究

目的了解某综合医院医院感染的危险因素,以便有针对性地采取预防措施,控制医院感染。方法采用病例对照研究方法和Logistic回归分析,找出医院感染的相关危险因素。结果经对228例病例与284例对照病例的研究分析,某医院感染患者的感染部位排在前五位的依次为下呼吸道、上呼吸道、泌尿道、胃肠道、手术切口。单因素分析显示,年龄、住院天数、入院诊断病症数≥3个、入院次数、气管插管、泌尿道插管、动静脉插管、化疗、激素、高转氨酶、抗菌药物治疗等26种单因素均与医院感染发生有关。多因素分析显示住院天数、科室、使用引流管、输血、静脉留置针、插胃管、高血压、抗菌药物治疗等为医院感染的影响因素。结论抗菌药物使用、介入性诊疗操作、高血压是某院医院感染的高危因素。

THE CASE-CONTROL STUDY ON RISK FACTORS FOR NOSOCOMIAL INFECTION

Objective To know the risk factors for nosocomial infection (NI) and provide methods for preventing NI.Methods Case-control study and logistic regression analysis were used to identify risk factors for nosocomial infections. Results A study on 228 cases and 284 controls showed that the top five most frequent sites of nosocomial infection were the lower respiratory tract, the upper respiratory tract, the urinary tract, the gastro-intestinal tract, and surgical incisions. Univariate analysis showed that 26 factors were related to nosocomial infection including age, duration of hospitalization, number of diseases diagnosed (equal to or greater than 3), frequency of hospitalization, tracheal intubation, urinary catheterization, arterial or venous catheterization, chemotherapy, hormones used, high levels of blood transaminases, antimicrobial treatment and so on. Multivariate analysis showed that the following factors were the potential risk factors: duration of hospitalization, department involved, use of drainage devices, blood transfusion, intravenous indwelling needles, stomach intubation, hypertension, and antimicrobial treatment. Conclusion Use of antimicrobials, invasive diagnostic and treatment operation and hypertension are main risk factors for nosocomial infection in a hospital.