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目的探讨老年糖尿病患者医院感染的临床特点及影响因素分析。方法选取2013年1月-2016年12月医院住院的老年糖尿病患者300例临床资料,分析患者感染率、病原菌分布并分析老年糖尿病医院感染相关影响因素。结果 300例老年糖尿病患者医院感染42例,感染率为14.0%;42例老年糖尿病医院感染患者中,呼吸道感染、泌尿道感染、皮肤软组织感染、消化道感染分别为15例、11例、8例、5例,构成比为35.7%、26.2%、19.0%、11.9%,42例老年糖尿病医院感染患者共培养出病原菌67株,其中革兰阳性菌、革兰阴性菌、真菌分别为12株、41株、14株,构成比分别为17.9%、61.2%、20.9%,革兰阳性菌主要为耐甲氧西林金黄色葡萄球菌和肠球菌,革兰阴性菌主要为铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌;老年糖尿病患者医院感染和年龄、病程、糖化血红蛋白、空腹血糖、并发症、住院时间、侵入性操作及应用抗菌药物种类有关(P<0.05);年龄>70岁、病程≥5年、糖化血红蛋白>9%、空腹血糖≥15mmol/L、有并发症、住院时间≥4周、有侵入性操作、抗菌药物种类≥2种是老年糖尿病患者医院感染的独立危险因素(P<0.05)。结论老年糖尿病患者医院感染率较高,主要感染部位为呼吸道感染,主要病原菌为革兰阴性菌,临床应对高龄、病程长、糖化血红蛋白和空腹血糖高、合并并发症、住院时间长、抗菌药物种类多、有侵入性操作患者高度重视,预防医院感染的发生。
Objective To investigate the clinical features and influential factors of nosocomial infections in elderly patients with diabetes mellitus. Methods From January 2013 to December 2016, 300 hospitalized elderly patients with diabetes mellitus were enrolled in this study. The infection rate, the distribution of pathogens and the influencing factors of nosocomial diabetes in elderly patients were analyzed. Results Among the 300 cases of elderly diabetic patients, 42 cases were nosocomial infection, the infection rate was 14.0%. Of the 42 cases of nosocomial diabetes inpatients, respiratory tract infections, urinary tract infections, skin and soft tissue infections, gastrointestinal infections were 15 cases, 11 cases and 8 cases , And 5 patients with 67 hospitalized patients with 35.7%, 26.2%, 19.0%, 11.9% and 42 elderly patients with diabetes mellitus were co-cultured with 67 pathogens, of which Gram-positive bacteria, Gram-negative bacteria and fungi were 12, 41 strains and 14 strains respectively. The constituent ratios were 17.9%, 61.2% and 20.9% respectively. Gram-positive bacteria were mainly methicillin-resistant Staphylococcus aureus and Enterococcus. Gram-negative bacteria were mainly Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii; nosocomial infection in elderly diabetic patients was related to age, course of disease, glycosylated hemoglobin, fasting blood glucose, complications, length of hospital stay, invasive procedures and application of antibacterials (P <0.05) 70 years old, duration of disease ≥ 5 years, glycosylated hemoglobin> 9%, fasting blood glucose ≥ 15mmol / L, complications, length of stay ≥ 4 weeks, invasive procedures, antibacterials ≥2 are nosocomial infections in elderly patients with diabetes Dangerous (P <0.05). Conclusion The prevalence of nosocomial infections in elderly patients with diabetes mellitus is high. The main infection sites are respiratory infections. The main pathogens are Gram-negative bacteria. Clinical response to advanced age, long course of disease, high glycosylated hemoglobin, fasting blood glucose, complications, long hospital stay, More patients with invasive procedures attach great importance to prevent the occurrence of nosocomial infections.