肝硬化患者医院感染率及危险因素

目的探讨肝硬化患者医院感染的特点及相关危险因素,以制定有效的策略,预防和减少医院感染的发生。方法收集某院2013年1—12月507例肝硬化住院患者的临床资料,对其医院感染现状,病原菌构成及危险因素进行分析。结果507例肝硬化患者中,48例发生医院感染,感染率为9.47%,感染部位主要以腹腔(31.25%)为主;细菌培养送检标本48份,送检率100.00%;共检出病原菌43株,其中革兰阴性(G-)菌25株(58.14%)、革兰阳性(G+)菌10株(23.26%)、真菌8株(18.60%)。危险因素单因素分析结果显示,不同年龄、住院时间、白细胞计数、清蛋白水平、肝功能分级、有无侵入性操作、有无并发症及是否预防性使用抗菌药物的肝硬化患者医院感染发生率比较,差异均有统计学意义(均P0.05)。结论肝硬化患者医院感染率较高,引起感染危险因素较多,应根据危险因素制定相应的干预措施,以减少肝硬化患者医院感染的发生。

Incidence and risk factors for healthcare associated infection in patients with liver cirrhosis

ObjectiveTo evaluate the characteristics and  risk factors for healthcare associated infections(HAI)  in patients with liver cirrhosis, so as to make effective strategies to prevent and control the occurrence of HAI.  MethodsClinical data of  hospitalized patients with liver cirrhosis in a hospital from January to December 2013 were collected,occurrence of HAI, distribution of pathogens，and risk factors were analyzed.ResultsOf 507 patients with liver cirrhosis,48 (9.47%) had HAI，the main infection site was intra abdominal （31.25%）；48 specimens(100.00%) were sent for bacterial culture; a total of 43 isolates of pathogens were detected，isolation rate of gram negative bacteria, gram positive bacteria,and fungi was 58.14% (n=25）, 23.26%（n=10）, and 18.60% (n=8）respectively；the incidence of HAI were different among cirrhosis patients with different age,  length of hospitalization, white blood count, albumin levels,the grade of liver function, invasive procedure, complications, prophylactic use of antimicrobial agents respectively (all P<0.05%).  ConclusionThe incidence of HAI in patients with liver cirrhosis is high, risk factors for HAI are multiple, corresponding intervention measures  should be formulated according to the risk factors, so as to reduce the occurrence of HAI.