摘要
目的探讨神经内科老年患者发生医院感染的高危因素及其防护干预措施。方法回顾性分析医院神经内科843例老年患者临床资料。结果发生医院感染率为11.98%,其中呼吸道感染占62.38%,泌尿道感染占23.76%,血液感染占5.94%;年龄≥70岁、合并基础疾病、有吸烟史、侵入性操作、糖皮质激素使用、广谱抗菌药物使用及意识不清、住院时间≥15d的患者医院感染发生率明显高,是引起医院感染的主要危险因素;共检出病原菌109株,其中革兰阴性菌68株占62.39%,前3位依次为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌,分别占22.94%、15.60%、11.93%;革兰阳性菌37株占33.94%,前两位为金黄色葡萄球菌、表皮葡萄球菌,分别占22.94%、5.50%;真菌4株,占3.67%。结论神经内科老年患者医院感染发生率高,导致医院感染的危险因素较多,针对危险因素进行有效地防护,有助于降低医院感染发生率。
OBJECTIVE To investigate the high risk factors for nosocomial infections in the elderly patients of neurological department of internal medicine so as to put forward the protection interventions.METHODS The clinical data of 843 elderly patients in neurological department of internal medicine were retrospectively analyzed.RESULTS The incidence rate of nosocomial infections was 11.98%,the respiratory tract infections accounted for 62.38%,urinary tract infections accounted for 23.76%,bloodstream infections accounted for 5.94%.The more than 70 years of age,combination of underlying disease,smoking history,invasive operation,use of corticosteroid or broad-spectrum antibiotics,unconsciousness,hospitalization duration more than 15 days were the main risk factors for the nosocomial infections.Totally 109 strains of pathogens were isolated,including 68（62.39%）strains of gram-negative bacteria,37（33.94%）strains of gram-positive bacteria,and 4（3.67%）strains of fungi.The top three species of gram-negative bacteria were Klebsiella pneumoniae（22.94%）,Escherichia coli（15.60%）,and Pseudomonas aeruginosa（11.93%）,the top two species of gram-positive bacteria were S.epidermidis（22.94%）and S.epidermidis（5.50%）.CONCLUSION The incidence rate of nosocomial infections is high in the elderly patients of the neurological department of internal medicine,there are many risk factors leading to the nosocomial infections.It is conducive to reduce the incidence of nosocomial infections to implement effective protection measures targeted to the risk factors.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第3期532-534,共3页
Chinese Journal of Nosocomiology
关键词
医院感染
神经内科
老年患者
防护
Nosocomial infection
Neurological department of internal medicine
Senile patient
Protection
