糖尿病患者合并医院感染的临床研究

目的 探讨糖尿病(DM)患者合并医院感染的特点.方法 选择2006年1月-2010年3月DM患者1180例作为研究对象,观察医院感染发生率、病原菌分布、医院感染相关因素及临床结果.结果 1180例患者中,合并医院感染120例,感染率为10.17％;其中呼吸系统感染43例、泌尿系统37例、皮肤及软组织22例、其他18例；具有感染典型表现80例.另40例症状不典型；标本培养阳性78份,阳性率为65.00％,检出革兰阴性杆菌50株,占64.10％,革兰阳性球菌18株,占23.08％,真菌10株,占12.82％;医院感染因素包括老年、DM并发症、侵入性操作、高血糖、预防性应用抗菌药物、住院时间长；医院感染患者的死亡率为12.50％,高于未发生医院感染患者的1.60％ (P＜0.05).结论 DM发生医院感染较高,与多种因素有关,可增加病死率,应提高DM合并医院感染的认识早诊断,针对危险因素进行干预以减少医院感染的发生.

Clinical research of nosocomial infections in diabetic patients

OBJECTIVE To explore the characteristics of nosocomial infections in diabetes mellitus(DM) patients.METHODS A total of 1180 cases of DM patients from Jan.2006 to Mar.2010 were chosen as the research objects;the incidence of nosocomial infections,the species of pathogens,related factors for nosocomial infections,and clinical outcomes were observed.RESULTS Of 1180 patients,co-infections occurred in 120 patients with the infection rate of 10.17% including 43 cases of respiratory system infections,37 cases of urinary tract infections,22 cases of skin and soft tissue infections,and 18 cases of other infections.There were 80 patients with typical manifestations of infection and 40 cases with untypical manifestations.Totally 78 specimens were cultured positive with the positive rate of 65.00%;there were 50(64.10%)strains of gram-negative bacilli,18(23.08%) strains of gram-positive bacilli,and 10(12.82%) strains of fungi.The related factors for nosocomial infections included the old age,DM complications,invasive operation,high blood glucose,prophylactic antibiotics,and long hospital stay.The mortality of the patients with nosocomial infections was 12.50% which was higher than 1.60% of the patients without nosocomial infections(P<0.05).CONCLUSION The incidence of nosocomial infections in DM patients is high,which is associated with many factors and can increase the mortality.It is necessary to improve the awareness of DM combined with nosocomial infections in early stage and take interventions according to the risk factors to reduce the nosocomial infections.