Hospital Infection Management Office, Binzhou People's Hospital, Binzhou Shandong.
Department of Gastroenterology, Kezhou People's Hospital, Atushi Xinjiang.
Medicine (Baltimore). 2021 May 28;100(21):e26158. doi: 10.1097/MD.0000000000026158.
The aim of this study was to analyze the distribution of pathogenic bacteria in hospitalized patients in elderly care centers under the mode of integration of medical care and elderly care service, and explore the influencing factors to reduce the health care-associated infection rate of hospitalized patients.A total of 2597 inpatients admitted to elderly care centers from April 2018 to December 2019 were included in the study. The etiology characteristics of health care-associated infections (HCAI) was statistically analyzed, univariate analysis, and multivariate logistic regression analysis method were used to analyze the influencing factors of HCAI.A total of 98 of 2597 inpatients in the elderly care centers had HCAI, and the infection rate was 3.77%. The infection sites were mainly in the lower respiratory tract and urinary tract, accounting for 53.92% and 18.63%, respectively. A total of 53 pathogenic bacteria were isolated, 43 of which (81.13%) were Gram-negative, mainly Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae, which respectively accounted for 24.53, 16.98, and 13.21%. 9 (16.98%) strains were Gram-positive, mainly Staphylococcus aureus and Enterococcus faecium, respectively accounting for 7.55 and 5.66%. Only 1 patient (1.89%) had a fungal infection. Multivariate logistic regression analysis indicated that total hospitalization days, antibiotic agents used, days of central line catheter, use of urinary catheter and diabetes were independent risk factors of nosocomial infection in elderly care centers (P < .05).Many factors can lead to nosocomial infections in elderly care centers. Medical staff should take effective intervention measures according to the influencing factors to reduce the risk of infection in elderly care facilities.
本研究旨在分析医养结合模式下老年护理中心住院患者的病原菌分布，并探讨影响因素，以降低住院患者的医源性感染率。
选取 2018 年 4 月至 2019 年 12 月在老年护理中心住院的 2597 例患者为研究对象，统计分析医源性感染（HCAI）的病因特征，采用单因素分析和多因素 logistic 回归分析方法分析 HCAI 的影响因素。
老年护理中心共 2597 例住院患者中发生 HCAI98 例，感染率为 3.77%。感染部位主要在下呼吸道和泌尿道，分别占 53.92%和 18.63%。共分离出 53 株病原菌，其中革兰阴性菌 43 株（81.13%），主要为大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌，分别占 24.53%、16.98%和 13.21%；革兰阳性菌 9 株（16.98%），主要为金黄色葡萄球菌和屎肠球菌，分别占 7.55%和 5.66%；仅 1 例（1.89%）真菌感染者。多因素 logistic 回归分析表明，总住院天数、抗生素使用、中心静脉导管留置天数、导尿管使用和糖尿病是老年护理中心医院感染的独立危险因素（P<0.05）。
许多因素可导致老年护理中心发生医院感染，医务人员应根据影响因素采取有效的干预措施，降低老年护理机构的感染风险。
