康复中心住院患者医院感染发病率及危险因素

目的探讨康复中心住院患者医院感染发病情况及其危险因素。方法回顾性分析某院康复中心2018年1—12月住院患者的临床资料,分析医院感染发生情况、感染部位及病原体种类,采用单因素及多因素logistic回归分析患者医院感染的危险因素。结果共收治住院患者4 118例,发生医院感染88例,95例次,医院感染发病率为2.14%,医院感染例次发病率为2.31%。脑出血患者医院感染发病率最高,为5.41%,例次发病率为6.21%。医院感染部位位于前3位的为泌尿道、下呼吸道、上呼吸道,分别占49.47%、27.37%、15.79%。95例次医院感染病例共分离出76株病原体,其中革兰阴性(G-)菌56株(占73.68%),革兰阳性(G+)菌15株(占19.74%)。多因素logistic回顾分析显示,男性、侵入性操作、意识障碍、低蛋白血症是康复科住院患者医院感染的独立危险因素(均P0.05)。结论男性患者、意识障碍、侵入性操作及低蛋白血症是康复中心住院患者医院感染的危险因素,应采取针对性预防控制措施,减少医院感染的发生。

Incidence and risk factors for healthcare-associated infection in hospita-lized patients in rehabilitation center

Objective To investigate the incidence and risk factors for healthcare-associated infection(HAI) in hospitalized patients in rehabilitation center. Methods Clinical data of hospitalized patients in a rehabilitation center from January to December 2018 were retrospectively analyzed, incidence of HAI, infection sites and pathogens were analyzed, risk factors for HAI were analyzed by univariate and multivariate logistic regression analysis. Results A total of 4 118 patients were hospitalized, 88 patients had 95 cases of HAI, HAI incidence and HAI case incidence were 2.14% and 2.31% respectively. The highest incidence of HAI was in patients with cerebral hemorrhage, incidence and case incidence were 5.41% and 6.21% respectively. The top three sites of HAI were urinary tract, lower respiratory tract and upper respiratory tract, accounting for 49.47%, 27.37% and 15.79% respectively. A total of 76 strains of pathogens were isolated from 95 cases of HAI, 56 of which (73.68%) were gram-negative bacteria and 15 (19.74%) were gram-positive bacteria. Multivariate logistic retrospective analysis showed that male, invasive operation, disturbance of consciousness and hypoproteinemia were independent risk factors for HAI in hospitalized patients in rehabilitation department (all P<0.05). Conclusion Male patients, disturbance of consciousness, invasive manipulation and hypoproteinemia are risk factors for HAI in patients in rehabilitation center, targeted prevention and control measures should be taken to reduce the occurrence of HAI.