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[目的]分析类风湿关节炎(RA)医院感染的临床特征,正确积极的防治医院感染。[方法]对2008年6月—2009年9月入住我院类风关内科的RA患者1 020例进行回顾性研究,将入选的类风湿关节炎患者的病例信息进行详细登记,将所得数据进行汇总分析。[结果]调查的1 020例RA患者,女性824例,男性196例,年龄17~92岁,平均年龄48岁。病程1个月~50年,平均病程8.47年。平均活动指数2.85。1 020例患者中,发生院内感染316例,感染率为30.98%,其中男性44例,女性272例,男性女性感染率分别为22.45%和33.01%。尿路感染、下呼吸道感染、上呼吸道感染及阴道炎占总体医院感染的94.04%,不同部位的感染好发的病原体存在差异。319例进行了病原体培养,其中304例培养阳性,15例培养无病原菌生长。培养结果共检测出39种病原体391株,革兰阴性菌172株,革兰阳性菌100株,真菌7株,衣原体102株,其检出率分别为43.99%、25.58%、4.34%和26.09%。男性医院感染以呼吸系统为主,而女性以尿路感染为主。[结论]本组风湿关节炎医院感染发生率高于国内平均水平,且支原体感染高于其他病种。医院感染的病原体谱逐年发生变化,耐药性也在改变。
[Objective] To analyze the clinical features of rheumatoid arthritis (RA) hospital infection and correct and positive prevention and treatment of nosocomial infection. [Methods] A retrospective study was performed on 1,020 patients with RA who were admitted to the department of internal medicine in our hospital from June 2008 to September 2009. The case information of patients with rheumatoid arthritis was enrolled in detail and the data were collected Summary analysis. [Results] The survey of 1,020 cases of RA patients, 824 women, 196 males, aged 17 to 92 years, mean age 48 years. Duration of 1 month to 50 years, the average duration of 8.77 years. The mean activity index was 2.85. Of the 020 patients, 316 were hospital nosocomial infections with an infection rate of 30.98%, including 44 males and 272 females, with male prevalence rates of 22.45% and 33.01%, respectively. Urinary tract infections, lower respiratory tract infections, upper respiratory tract infections and vaginitis accounted for 94.04% of the total nosocomial infections, and pathogens in different parts of the epidemic were different. 319 cases were pathogen cultured, of which 304 were positive for culture, 15 cases of pathogen-free culture growth. 391 strains of pathogens, 172 strains of Gram-negative bacteria, 100 strains of Gram-positive bacteria, 7 strains of fungi and 102 strains of Chlamydia were detected. The detection rates were 43.99%, 25.58%, 4.34% and 26.09% respectively. . Male hospital infection mainly respiratory system, while women with urinary tract infection. [Conclusion] The incidence of hospital-acquired rheumatoid arthritis in this group is higher than the national average, and mycoplasma infection is higher than other diseases. The pathogen spectrum of nosocomial infections changes year by year and resistance is changing.