医院感染性腹泻的临床特征分析

目的 为了解医院感染性腹泻的临床特征，制定有效的预防控制措施。方法 对l999—2000年度的54903例住院患者进行前瞻性和回顾性调查，并将医院感染性腹泻患者分为A、B两组，腹泻前用过抗菌药物者为A组，腹泻前未用过抗菌药物者为B组；分别观察、记录两组患者的发病时间、伴随症状、大便性状及致病菌结果。结果 l999—2000年度医院感染性腹泻发病率为0.85％，占医院感染总数的l7．04％，居医院感染的第3位；A组有51．31％在人院lOd后发病，60．95％持续腹泻5--lOd，伴发热者仅20．99％；致病菌中主要为G—菌和真菌，与B组比较差异有显著性。结论 预防控制医院感染性腹泻，除加强医院环境和餐饮管理外，更重要的是加强抗菌药物临床应用管理。

Clinical Characteristic Analysis of Nosocomial Infected Diarrhea

OBJECTIVE To investigate the clinical characteristic of nosocomial infected diarrhea and make effective measures to prevent and control it. METHODS Retrospective and prospective epidemiological survey was used on 54903 hospitalized cases from 1999 to 2000. Diarrhea patients were grouped as A and B. Before diarrhea, patients in group A used antibiotics since admission, while group B did not use any antibiotics. The time of onset, concomitant symptoms, feces properties and pathogens were surveyed and recorded. RESULTS Incidence of nosocomial infected diarrhea was 0.85% between 1999 and 2000. Diarrhea infection is the third and accounts for 17.04 % in all hospital infections. 51.31% of group A developed diarrhea after 10 days since hospitalization, 60.95% persisted for 5 10 days, only 20.99% had concomitant fever. The main pathogens were Gram positive bacteria and fungi. There is a significant difference compared with group B. CONCLUSIONS In order to prevent and control the nosocomial infected diarrhea the management of hospital environment, and the food quality should be improved, but it is more important to strengthen the antibiotic usage in hospital.