中国医学前沿杂志（电子版）

中国医学前沿杂志（电子版） ›› 2019, Vol. 11 ›› Issue (10): 149-152.doi: 10.12037/YXQY.2019.10-33

• 论著 • 上一篇    下一篇

老年肺结核患者医院感染的病原学特点及其危险因素分析

姜红1，史生华1，韩晓萍1，保成兰1，李桂玲2   

  1. 1．青海省第四人民医院　结核科，西宁　810000 ；2．青海省第四人民医院　消毒供应中心，西宁　810000
  • 出版日期: 2019-11-01
  • 通讯作者: 李桂玲　E-mail：710020191@qq.com

Etiological characteristics and risk factors of nosocomial infection in elderly patients with pulmonary tuberculosis

JIANG Hong1, SHI Sheng-hua1, HAN Xiao-ping1, BAO Cheng-lan1, LI Gui-ling2   

  1. 1. Department of Tuberculosis, the Fourth People's Hospital of Qinghai Province, Xining 810000, China; 2. Disinfection Supply Centre, the Fourth People's Hospital of Qinghai Province, Xining 810000, China
  • Revised: 2019-11-01
  • Contact: LI Gui-ling, E-mail: 710020191@qq.com

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摘要：

目的 探讨老年肺结核患者医院感染的病原学特点及其危险因素。方法 收集2016年1月至2017年6月本院感染科收 治的301例老年肺结核患者为调查对象，将发生医院感染的患者纳入感染组，未发生医院感染的患者纳入未感染组，收集感染组患者的痰液、血液、尿液等临床标本进行分离培养鉴定，并分析病原学特点。采用单因素和多因素Logistic回归分析探 讨导致老年肺结核患者发生医院感染的相关危险因素。结果 301例肺结核患者住院期间共32例发生医院感染，感染率为 10.6%，主要发生于呼吸系统，其次为消化系统和泌尿系统。32例医院感染患者标本中共分离培养出57株病原菌，主要为真菌和革兰氏阴性菌。多因素Logistic回归分析显示，复治肺结核、合并基础疾病、有侵入性操作、抗生素使用种类＞ 2种均 为导致老年肺结核患者发生医院感染的独立危险因素（ 均P ＜ 0.05）。结论 老年肺结核患者医院感染的发生率较高，病原菌主要为真菌和革兰氏阴性菌。影响老年肺结核患者医院感染的危险因素较多，临床上需要加强对复治肺结核、合并基础 疾病的老年患者的监测，减少侵入性操作和抗生素的联合使用，以降低老年肺结核患者医院感染发生率。

关键词: 肺结核, 医院感染, 老年, 病原学特点, 危险因素

Abstract:

Objective　To investigate the etiological characteristics and related risk factors of nosocomial infection in elderly patients with pulmonary tuberculosis. Method　301 elderly patients with pulmonary tuberculosis admitted in our hospital from January 2016 to June 2017 were collected. All patients with nosocomial infection were included in infection group, patients who did not have nosocomial infection were included in uninfected group, the sputum, blood, urine and other clinical specimens of the infected group were collected for isolation, the pathogenic characteristics were analyzed. Univariate and multivariate Logistic regression analysis was used to explore the risk factors of nosocomial infection in elderly patients with pulmonary tuberculosis. Result　There were 32 cases of nosocomial infection in 301 cases of pulmonary tuberculosis, and the nosocomial infection rate was 10.6%. The nosocomial infection mainly occurred in respiratory system, the second was digestive system and urinary system infection, and 32 cases of nosocomial infection were isolated and cultivated 57 strains of pathogenic bacteria, mainly fungi and Gram-negative bacteria. Multivariate Logistic regression analysis showed that retreatment of pulmonary tuberculosis, combined with underlying diseases, invasive operation, and types of antibiotics use were independent risk factors for nosocomial infection in elderly patients with pulmonary tuberculosis (all P ＜ 0.05). Conclusion　The incidence of nosocomial infection in elderly patients with pulmonary tuberculosis is relatively high. Fungi and Gram-negative bacteria are the main pathogens. There are many risk factors affecting nosocomial infection in elderly patients with pulmonary tuberculosis. It is necessary to strengthen the monitoring of retreated pulmonary tuberculosis patients with underlying diseases and reduce the combination of invasive operation and antibiotics in order to reduce the nosocomial infection rate in elderly patients with pulmonary tuberculosis.

Key words: Pulmonary tuberculosis, Nosocomial infection, Elderly, Risk factor, Etiological characteristic

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