老年脑卒中患者医院感染病原学及危险因素分析

发布时间：2018-05-25 22:50

本文选题：老年 + 脑卒中　；参考：《中华医院感染学杂志》2017年19期

【摘要】：目的探讨分析老年脑卒中患者医院感染病原学特点及其危险因素。方法回顾性分析2016年1-12月医院收治的986例老年脑卒中患者临床资料及其临床标本病原菌检测结果,采用单因素分析及多因素logistic回归分析,分析老年脑卒中医院感染危险因素。结果 986例老年脑卒中患者中,发生医院感染患者191例,医院感染率19.37%;191例发生医院感染的老年脑卒中患者,共分离菌株259株,其中从痰液中分离菌株141株占54.44%;革兰阴性菌199株占76.83%,革兰阳性菌55株占21.24%,真菌5株占1.93%;单因素分析结果显示,年龄、住院时间、脑卒中类型、意识障碍、吞咽障碍、侵入性操作、低蛋白血症、糖尿病以及多脏器衰竭与老年脑卒中患者医院感染有关(P0.05);多因素logistic回归分析显示,住院时间、侵入性操作、糖尿病以及多脏器衰竭进入回归模型,为医院感染发生的独立危险因素(P0.05)。结论老年脑卒中患者医院感染发病率较高,主要以呼吸道感染为主,检测病原菌主要为革兰阴性菌,住院时间、侵入性操作、糖尿病以及意识障碍为老年脑卒中患者医院感染发生的独立危险因素。
[Abstract]:Objective to investigate the etiological characteristics and risk factors of nosocomial infection in elderly stroke patients. Methods retrospective analysis was made on the clinical data and the results of pathogenic bacteria in clinical specimens of 986 elderly stroke patients admitted in our hospital from January to December 2016. Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors of nosocomial infection in elderly stroke patients. Results among 986 senile stroke patients, 191 were nosocomial infection, and 19.37 were nosocomial infection. 259 strains were isolated. Among them, 141 strains were isolated from sputum, 199 Gram-negative bacteria accounted for 76.83%, 55 Gram-positive bacteria accounted for 21.2443, and 5 fungi accounted for 1.93%. Univariate analysis showed that age, length of stay in hospital, type of stroke, disturbance of consciousness, dysphagia, and dysphagia, Invasive operation, hypoproteinemia, diabetes, and multiple organ failure were associated with nosocomial infection in elderly stroke patients (P 0.05). Multivariate logistic regression analysis showed that hospitalization time, invasive operation, diabetes and multiple organ failure entered the regression model. It is an independent risk factor for nosocomial infection. Conclusion the incidence of nosocomial infection in elderly patients with stroke is high, mainly respiratory tract infection, the main pathogenic bacteria are Gram-negative bacteria, hospitalization time, invasive operation. Diabetes mellitus and disturbance of consciousness are independent risk factors for nosocomial infection in elderly stroke patients.
【作者单位】：缙云县人民医院检验科;浙江大学医学院附属邵逸夫医院康复医学科;
【基金】：浙江省医药卫生一般研究计划基金资助项目(2015KYA139)
【分类号】：R743.3

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