老年痴呆患者医院感染危险因素

Risk factors for healthcareassociated infection in senile dementia patients

摘要:

目的了解老年痴呆患者医院感染的危险因素，以期采取有效的护理措施降低其医院感染发生率。方法采用回顾性调查方法，对2011年1月—2013年6月某院干部病房住院、年龄≥60岁的82例老年痴呆患者临床资料进行调查分析。结果82例老年痴呆患者中，发生医院感染28例，医院感染发生率为34.15%。感染部位以下呼吸道为主（15例，53.57%），其次为泌尿道（6例，21.43%）。单因素分析结果显示，长期卧床、住院时间长、吞咽障碍、保留导尿管、不合理使用抗菌药物、合并肿瘤和低蛋白血症是老年痴呆患者医院感染的危险因素（均P＜0.05）。分离病原菌以革兰阴性杆菌（40株，62.50%）为主，居前3位的病原菌依次是肺炎克雷伯菌（12株，18.75%）、大肠埃希菌（10株，15.63%）和铜绿假单胞菌（8株，12.50%）。结论了解老年痴呆患者医院感染的危险因素及常见病原菌，有助于采取有效的护理措施，降低和预防医院感染的发生。

Abstract:

ObjectiveTo evaluate the risk factors for healthcareassociated infection(HAI) in senile dementia patients, so as to adopt effective nursing measures to reduce the incidence of HAI. MethodsClinical data of 82 senile dementia patients aged≥60 years and hospitalized between January 2011 and June 2013 were analyzed retrospectively. ResultsOf 82 patients, 28 (34.15%) developed HAI. The main infection site was lower respiratory tract（n=15，53.57%）, followed by urinary tract(n=6，21.43%）. Univariate analysis revealed that risk factors for HAI in senile dementia patients were bedridden, long length of hospital stay , dysphagia,  indwelling urinary catheter, irrational use of antimicrobial agents, combined with tumor, and  hypoproteinemia (all P<0.05). The main isolated bacteria were gramnegative bacilli(n=40,62.50%) , the top three pathogens were Klebsiella pneumoniae（n=12，18.75%）, Escherichia coli（n=10，15.63%）, and Pseudomonas aeruginosa （n=8，12.50%）. ConclusionRealizing the risk factors and common pathogens of HAI in senile dementia patients is helpful for taking effective measures to prevent and control the incidence of HAI .