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目的:调查本院医院感染状况、危险因素及耐药菌的分布。方法:对住院的11 096例患者进行医院感染监测,分析医院感染标本来源科室及多重耐药菌的分布状况,并对医院感染的危险因素进行logistic单因素回归分析。结果:11 096例住院患者中发生医院感染330例,感染率为2.97%,标本主要来源于痰液及尿液,主要发生在ICU(28.2%),呼吸内科(18.5%)及普通外科(15.0%);患者的年龄、住院时间、使用二联以上抗生素、侵入性操作、抗肿瘤治疗、使用免疫抑制剂或激素是医院感染的独立危险因素,差异均有统计学意义(P<0.05);多重耐药菌感染以产超广谱β内酰胺酶细菌最多(45.8%),其次为多重耐药鲍曼不动杆菌为(20.6%)、多重耐药铜绿假单胞菌(12.7%)。结论:医院感染标本主要来源于ICU和呼吸内科,年龄、住院时间,滥用抗生录是医院感染的危险因素,产超广谱β内酚胺酶细菌是主要耐药菌。
Objective: To investigate the hospital infection, risk factors and the distribution of drug-resistant bacteria in our hospital. Methods: 11 096 hospitalized patients were monitored for nosocomial infection. The distribution of nosocomial infection specimens and multidrug-resistant bacteria were analyzed. Logistic regression analysis was used to analyze the risk factors of nosocomial infection. Results: Of the 11 096 hospitalized patients, 330 cases of nosocomial infection occurred and the infection rate was 2.97%. The specimens mainly came from sputum and urine, mainly in ICU (28.2%), respiratory medicine (18.5%) and general surgery %). The age, length of hospital stay, use of antibiotics in combination with two or more, invasive procedures, antitumor therapy, and immunosuppressive agents or hormones were independent risk factors for nosocomial infection. The differences were statistically significant (P <0.05). Multidrug-resistant strains produced the most bacteria (45.8%) with extended-spectrum β-lactamases, followed by multi-drug resistant Acinetobacter baumannii (20.6%) and multi-drug resistant Pseudomonas aeruginosa (12.7%). CONCLUSIONS: Nosocomial infection specimens mainly come from ICU and respiratory medicine. Age, length of hospital stay, and abuse of antibiotics are the risk factors of nosocomial infections. ESBLs producing bacteria are the major drug-resistant bacteria.