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目的探讨哮喘患者发生医院感染的临床特点,分析相关因素并提出可行的预防对策,以控制医院感染的发生。方法选择2007年5月-2013年5月收治的78例发生医院感染哮喘患者作为研究对象,采集患者标本进行细菌培养及药敏试验,对病原菌和相关影响因素采用SPSS15.0软件进行统计分析,对有显著性差异的影响因素进行多因素logistic回归分析。结果收治的2 340例哮喘患者中78例发生医院感染,感染率为3.33%;感染部位以呼吸道为主,占65.39%;共分离出病原菌95株,其中革兰阴性菌69株占72.64%、革兰阳性菌22株占23.16%、真菌4株占4.20%,检出前5位的病原菌为流感嗜血菌、肺炎克雷伯菌、金黄色葡萄球菌、卡他莫拉菌和大肠埃希菌,分别占22.11%、15.80%、14.75%、12.63%、10.53%;经统计分析发现,发病季节、住院时间、侵入性操作、抗菌药物种类、激素应用及有糖尿病史是哮喘患者发生医院感染的相关影响因素,差异有统计学意义(P<0.05)。结论哮喘患者发生医院感染率较高,在临床治疗过程中,应注意相关影响因素,做好有效的预防措施,提高治疗效果降低医院感染的发生。
Objective To investigate the clinical characteristics of nosocomial infections in asthmatic patients, analyze related factors and put forward feasible preventive measures to control the occurrence of nosocomial infections. Methods Seventy-eight patients with hospital-acquired asthma who were admitted to our hospital from May 2007 to May 2013 were enrolled in this study. Specimens of patients were collected for bacterial culture and drug susceptibility testing. Statistical analyzes were carried out on pathogens and related factors using SPSS15.0 software. Multivariate logistic regression analysis of influencing factors with significant differences. Results Among the 2 340 cases of asthma admitted to hospital, 78 cases had nosocomial infection with the infection rate of 3.33%. The main infection area was respiratory tract, accounting for 65.39%. 95 strains of pathogens were isolated, of which 69 strains were Gram-negative bacteria accounting for 72.64% 22 strains of Gram-positive bacteria accounted for 23.16%, 4 strains of fungi accounted for 4.20%, the top 5 pathogenic bacteria were Haemophilus influenzae, Klebsiella pneumoniae, Staphylococcus aureus, Moraxella catarrhalis and Escherichia coli Accounting for 22.11%, 15.80%, 14.75%, 12.63% and 10.53% respectively. According to the statistical analysis, the incidence of nosocomial infections was found in the seasons of onset, length of hospital stay, invasive procedures, antibacterials, hormone application and diabetes mellitus Of the relevant factors, the difference was statistically significant (P <0.05). Conclusions The incidence of nosocomial infection in asthma patients is high. During the course of clinical treatment, we should pay attention to the relevant factors, make effective preventive measures, improve the therapeutic effect and reduce the incidence of nosocomial infections.