失代偿期肝硬化患者医院感染危险因素及病原学特点探讨

发布时间：2018-03-31 05:23

本文选题：失代偿期肝硬化　切入点：医院感染　出处：《中华医院感染学杂志》2017年21期

【摘要】：目的探讨失代偿期肝硬化患者医院感染的病原学特点和危险因素,以期预防和控制医院感染,改善预后。方法选择2010年1月-2016年12月医院收治的失代偿期肝硬化患者682例,采集血液、痰液、咽拭子等标本进行培养,探讨医院感染率及病原学特点,进行失代偿期肝硬化患者医院感染的单因素和多因素分析。结果682例失代偿期肝硬化患者发生医院感染68例,感染率为9.97%,感染部位主要以呼吸道25例为主,占36.76%,腹腔21例占30.89%;感染病原菌主要为革兰阴性菌41株占60.29%,革兰阳性菌17株占25.00%,真菌10株占14.71%,其中革兰阴性菌以大肠埃希菌为主,革兰阳性菌以表皮葡萄球菌为主,真菌均为酵母菌属;多因素logistic研究结果显示:年龄60岁、住院时间4周、有侵入性操作、合并并发症、预防使用抗菌药物、肝功能child分级为C级等为失代偿期肝硬化患者医院感染的危险因素(P0.05)。结论失代偿期肝硬化患者医院感染的危险因素较多,应合理选择抗菌药物,并实行针对性的预防措施。
[Abstract]:Objective to investigate the etiological characteristics and risk factors of nosocomial infection in patients with decompensated cirrhosis in order to prevent and control nosocomial infection and improve prognosis. Methods 682 patients with decompensated cirrhosis were selected from January 2010 to December 2016. Blood, sputum, pharynx swabs and other specimens were collected for culture, and the nosocomial infection rate and etiological characteristics were discussed. Univariate and multivariate analysis of nosocomial infection in patients with decompensated cirrhosis was carried out. Results 68 cases of nosocomial infection occurred in 682 patients with decompensated cirrhosis, the infection rate was 9.97, and the main site of infection was respiratory tract in 25 cases. The main pathogens were Gram-negative bacteria (41 strains, 60.29), Gram-positive bacteria (17 strains, 25.00), fungi (10 strains, 14.71), Gram-negative bacteria (Escherichia coli) and Gram-positive bacteria (Staphylococcus epidermidis), among which Gram-negative bacteria were mainly Escherichia coli and Gram-positive bacteria were Staphylococcus epidermidis. The results of multivariate logistic study showed that the age of 60 years, hospital stay for 4 weeks, invasive operation, complications, prevention of use of antimicrobial agents, Child grade C was the risk factor of nosocomial infection in decompensated cirrhosis patients. Conclusion there are many risk factors for nosocomial infection in decompensated cirrhosis patients.
【作者单位】：海南医学院第二附属医院消化内科;
【基金】：海南省自然科学基金资助项目(309118)
【分类号】：R575.2

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