医院感染危险因素的回顾性队列研究

[目的]探讨综合性医院的医院感染发生状况及其危险因素。[方法]采用回顾性队列研究,按比例分层随机和系统随机方法抽取某三级医院2005年1 050例住院病人为研究对象进行研究。[结果]住院病人医院感染率8.4%(88/1 050);感染部位以下呼吸道为主(26.1%),其次是消化道和上呼吸道(25.0%和21.6%);院感率在高干病区最高46.7%(7/15)。年龄、性别、病区、总住院时间、感染前使用抗生素和介入性诊疗是院感的关联因素;logistic回归分析筛选出感染前使用抗生素、介入性诊疗、性别和病区是主要危险因素;感染前抗生素使用种数越多,发生院感危险性越大。[结论]感染前使用抗生素和介入性诊疗是医院感染的主要危险因素。严格把握抗生素应用指征、规范各类介入性诊疗操作,将有利于预防和控制住院病人发生医院感染。

A Retrospective Cohort Study on Risk Factors of Hospital Infection

[Objective] To explore the incidence of hospital infection and its risk factors.[Method] 1 050 hospitalized patients in one hospital of Fuzhou in 2005 were investigated with stratified and systematic random sampling by retrospective cohort study.[Result] The incidence was 8.4%(88/1 050).The locuses of infection were lower respiratory tract(26.1%),digestive tract(25.0%) and upper respiratory tract(21.6%).The highest incidence was in senior carder wards 46.7%(7/15).The infection was significantly associated with age,gender,sections of hospital,length of hospitalization,using antibiotic before the infection and intervening treatment.The main risk factors by logistic regression analysis were using antibiotics before the infection,intervening treatment,gender and section.The more antibiotic kinds were used before the infection,the greater risk of the infection was.[Conclusion] Using antibiotics before the infection and intervening treatment are the major risk factors of hospital infection.Using antibiotics reasonably and regulating intervening treatment will be very important for hospital infection prevention and control.