医院感染危险因素暴露率长期变动趋势及其与医院感染发病率的关系

目的研究某医院1993～2000年医院感染危险因素暴露率的变动趋势,分析危险因素暴露率与医院感染发病率的关系. 方法采用前瞻性调查的方法监测某医院1993～2000年所有住院患者医院感染的发生、危险因素暴露情况. 结果 6项危险因素的暴露率呈上升趋势,为患糖尿病、血液系统疾病、化疗、重症监护(ICU)、泌尿道插管、气管内全麻;8项危险因素的暴露率呈下降趋势,为患肝硬化、慢性阻塞性肺疾患、使用免疫抑制剂、放疗、手术、使用呼吸机、胸骨腰穿刺、使用内镜;其他7项危险因素,为患癌症、昏迷、动静脉插管、气管切开、引流、心脏起搏器、血液或腹膜透析的暴露率无明显变化;患糖尿病、血液系统疾病2项因素的暴露率与医院感染发病率呈负相关;患慢性阻塞性肺疾患、放疗、手术、使用呼吸机、胸骨腰穿刺、使用内镜等6项因素的暴露率与医院感染发病率呈正相关. 结论部分危险因素暴露率的下降对医院感染发病率的下降有关.

Relationship Between Exposure Rates of Risk Factors of Nosocomial Infection and Nosocomial Infection Incidence Rates:Secular Trends of Exposure Rates of Risk Factors of Nosocomial Infection

OBJECTIVE To study the trends of exposure rates of risk factors of nosocomial infection from 1993 to 2000 and relationship between exposure rates of risk factors of nosocimial infection and nosocomial infection incidence rates. METHODS Nosocomial infection and risk factors in hospitalized patients in a hospital were monitored by prospective investigation from 1993 to 2000. RESULTS There was an upward trend in the exposure rates of six risk factors, which were suffering diabetes, suffering blood diseases, chemotherapy, exposure to ICUs, indwelling urinary catheters, and general anesthesia from respiratory tract. There was a downward trend in the exposure rate of eight risk factors, which were suffering hepatic cirrhosis, suffering chronic obstructive pulmonary disease, operation, using respiratory machine, chest-or-marrow-or-lumbar puncture, and using endoscope. The exposure rates of other seven risk factors, suffering cancers, cataphora, arterial or venous cannula, respiratory cut, drainage, using cardiac pacemaker, and hemo-or peritoneal dialysis, had not significantly changed. There was an inverse correlation between the case-times of nosocomial incidence rate and exposure of two risk factors, which were suffering diabetes, and suffering blood diseases. There was a positive correlation between the case-times of nosocomial incidence rate and exposure of six risk factors, which were suffering chronic obstructive pulmonary disease, radiotherapy, operation, using respiratory machine, chest-or-marrow-or-lumbar puncture, and using endoscope. CONCLUSIONS The downward of exposure rates of partial risk factors has contribution to the decrease in incidence rates of nosocomial infection.