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目的对心血管病住院患者医院感染的临床特点及危险因素进行分析,找到医院感染的控制方法。方法选取2013年1月至2015年3月830例心血管病住院患者,通过分析病菌感染及临床特征两类指标找到医院感染的临床特点及危险因素。结果 830例心血管病住院患者中出现81例医院感染患者,感染率为9.76%。感染主要途径为上、下呼吸道。该次从81例患者中分离出81种病原菌,分布的结果为革兰阴性杆菌、革兰阳性球菌、真菌构成比例分别为69.14%、24.69%、6.17%。医院感染患者单因素数据分析结果为合并症、心功能异常、侵袭性操作、使用抑酸剂、预防应用抗生素,患者住院天数与感染也有线性的关系。医院感染患者多因素条件Logistic回归分析,侵袭性操作、有合并症、预防应用抗生素、住院时间的β值分别为2.412、2.213、1.461、0.956。结论心血管病住院患者医院感染是较为常见的医疗疾病,为了减少这种疾病,需控制革兰阴性杆菌的感染及扩散;在日常医护治疗中优化护理及管理工作,提高患者的免疫力;避免过多使用抗生素;减少患者住院时间,从这几个危险因素着手控制可减少心血管病住院患者医院感染发生的概率。
Objective To analyze the clinical characteristics and risk factors of nosocomial infection in hospitalized patients with cardiovascular disease and find out the control methods of nosocomial infection. Methods 830 hospitalized patients with cardiovascular diseases from January 2013 to March 2015 were selected. The clinical characteristics and risk factors of nosocomial infection were found by analyzing two kinds of indicators of bacterial infection and clinical features. Results A total of 81 hospitalized patients with cardiovascular diseases were found in 830 patients, the infection rate was 9.76%. The main route of infection is upper and lower respiratory tract. The 81 pathogens isolated from 81 patients, the distribution of Gram-negative bacteria, Gram-positive cocci, fungi constitute the proportion of 69.14%, 24.69%, 6.17%. The results of univariate analysis of nosocomial infections were comorbidities, abnormal cardiac function, invasive procedures, the use of antacids, antibiotic prophylaxis, and a linear relationship between days of hospitalization and infection. Logistic regression analysis of multivariate logistic regression analysis showed that patients with nosocomial infection had invasiveness, comorbidities, antibiotic prophylaxis, and length of hospital stay of 2.412,2.213,1.461,0.956 respectively. Conclusions Nosocomial infections in hospitalized patients with cardiovascular diseases are the most common medical diseases. In order to reduce this disease, infection and spread of Gram-negative bacilli need to be controlled. Care and management should be optimized in daily medical care to improve patient’s immunity. Avoidance of Excessive use of antibiotics; reduce patient hospital stay, starting from the control of these few risk factors can reduce the incidence of hospital-acquired cardiovascular disease in patients with the probability of occurrence.