2018—2020年某市急性有机磷农药中毒患者医院感染危险因素

Risk factors for healthcare-asssociated infection in patients with acute organophosphorus pesticide poisoning in a city from 2018 to 2020

摘要:

目的 分析周口市急性有机磷农药中毒患者医院感染的危险因素，为采取针对性干预措施提供科学依据。 方法 采用回顾性研究方法，选取周口市9所医院2018—2020年收治的急性有机磷农药中毒患者为研究对象，分析医院感染情况及其影响因素。 结果 共收集959例急性有机磷农药中毒患者，医院感染发病率为5.6%，医院感染部位主要为下呼吸道（43例次，占76.8%）。急性有机磷农药中毒医院感染患者的年龄、机械通气日数高于非医院感染组患者，差异有统计学意义（均P < 0.05）。有慢性呼吸道疾病史、胆碱酯酶活性降低、重度中毒、昏迷、侵入性操作及使用糖皮质激素、免疫抑制剂、抗菌药物患者的医院感染发病率较高，差异均有统计学意义（均P < 0.05）。多因素logistic回归分析显示，长期机械通气、慢性呼吸道疾病史、免疫抑制剂使用史和抗菌药物使用史是急性有机磷农药中毒患者发生医院感染的独立危险因素（均P < 0.05）。 结论 急性有机磷农药中毒患者医院感染发病率高，主要为下呼吸道感染，应针对其影响因素采取综合预防措施，以减少其医院感染的发生。

关键词:有机磷;中毒;医院感染;危险因素

Abstract:

Objective To analyze the risk factors for healthcare-asssociated infection (HAI) in patients with acute organophosphorus pesticide (OP) poisoning in Zhoukou City, provide scientific basis for taking targeted intervention measures. Methods Patients with acute OP poisoning treated in 9 hospitals in Zhoukou City from 2018 to 2020 were selected for retrospective study, HAI and its influencing factors were analyzed. Results A total of 959 patients with acute OP poisoning were collected, incidence of HAI was was 5.6%, the main HAI site was lower respiratory tract (n=43, 76.8%). The age and days of mechanical ventilation in cute OP poisoning patients with HAI were significantly higher than those in patients without HAI (both P < 0.05). Incidence of HAI was higher in patients with chronic respiratory diseases, low cholinesterase activity, severe poisoning, coma, invasive procedure, as well as use of glucocorticoid, immunosuppressive agents and antimicrobial agents, differences were all statistically signi-ficant (all P < 0.05). Multivariate logistic regression analysis showed that long-term mechanical ventilation, history of chronic respiratory diseases, use history of immunosuppressive agents and and antimicrobial agents were independent risk factors for HAI in patients with acute OP poisoning (all P < 0.05). Conclusion Incidence of HAI in patients with acute OP poisoning is high, mainly lower respiratory tract infection, comprehensive preventive mea-sures should be taken according to its influencing factors, so as to reduce the incidence of HAI.

Key words:organic phosphorus;poisoning;healthcare-asssociated infection;risk factor