某医院1993年至2000年下呼吸道医院感染分布及其危险因素监测

目的 :了解下呼吸道医院感染的发生与分布 ,分析其危险因素 ,为预防和控制医院感染提供依据。方法 :对某院 1 993年至 2 0 0 0年前瞻监测的 1 2 6 6 6 5例住院患者中发生的 1 0 4 7例下呼吸道医院感染的分布规律和危险因素进行分析。结果 :下呼吸道医院感染率为 0 .83% ,占所有感染的 1 7.90 %。男性感染率显著高于女性 (分别为 1 .0 2 %和 0 .6 0 % ,P <0 .0 5 )。感染率的年龄分布呈“V”型 ,<3岁和≥ 6 0岁人群的感染率显著升高。内科和儿科感染率分别为 1 .34%和 1 .33%。 1 993年至 2 0 0 0年 8a间的感染率呈显著下降趋势。Logistic回归分析显示下呼吸道医院感染的独立危险因素为年龄 (OR =1 .0 2 )、免疫抑制剂治疗 (OR =2 .34)、化疗 (OR =2 .4 8)、患肿瘤 (OR =1 .31 )、合并慢性阻塞性肺疾病 (OR =2 .32 )、住ICU病房 (OR =2 .84 )、住院期间发生昏迷 (OR =3.2 6 )、气管切开 (OR=1 0 .4 4 )、接受透析治疗 (OR =5 .2 5 )和骨 /腰穿刺 (OR =2 .0 5 )等。结论 :基础疾病、侵袭性操作、免疫功能低下、住ICU等是发生医院感染的主要危险因素。建立完善的医院内感染监控系统 ,针对高感染危险人群开展前瞻性目标性监测是降低下呼吸道医院感染率的有效途径

Study on distributions and risk factors of lower respiratory tract infection in a hospital from 1993 to 2000

Aim: To understand the epidemiologic characteristics of lower respiratory tract infection and to analysis its risk factors in order to prevent and control nosocomial infection. Methods: The epidemiological study of lower respiratory tract infection was carried out on 1 047 cases among 126 665 inpatients in a hospital from 1993 to 2000. Results: The nosocomial infection rate of lower respiratory tract was 0.83%, the infectious proportion from total patients was 17.90%. Male and female nosocomial infection rate were 1.02% and 0.60%, respecetively. The male rate was significantly higher than that of the female ( P <0.05), the age distribution was "V".The patients who were younger than 3 or older than 60 have higher incidence of nosocomial infection. Internal Medicine and Paediatric nosocomial infection incidence were 1.34% and 1.33%, respecetively. The seculare trends of infection rate was decreased 1993 through 2000. The logistic regression analysis shows that the independent risk factors for NP were age ( OR =1.02), immunosuppressive therapy ( OR =2.34), chemotherapy ( OR =2.48), cancer ( OR =1.31), chronic obstructive pulmonary disease (COPD), ( OR =2.32), ICU ( OR =2.84), coma ( OR =3.26), dialysis ( OR =10.44), hemodialysis ( OR =5.25), bone or waist puncturing ( OR =2.05). Conclusions: To get 17 correlating factors of NP. Basic diseases, invasive operation, immunologic inadequacy and ICU are mainly risk factors. The better way of reducing the incidence is to establish the monitoring system, carrying out the prospective surveillance, target surveillance.