CAJ | 학술논문

目的：探讨本院急诊科病房革兰阳性菌感染患者的危险因素，为其防治提供科学依据。方法回顾性分析本院急诊科感染病例中103例革兰阳性菌感染情况。采用单因素分析和多因素Logistic回归分析其危险因素。结果分离患者血液、尿液、痰、胆汁、穿刺液、分泌液、脓汁及伤口引流液送检标本共1796份，检出阳性标本631份，总菌株培养检出阳性率为35.1％。分离出病原菌共593株，其中革兰阳性菌169株。465例感染病例中有103例检获革兰阳性菌感染，占22.2％。多因素Logistic回归分析发现，中心静脉置管、慢性肾功能不全、住院天数≥20 d是急诊科革兰阳性菌感染的独立危险因素。结论医院急诊科革兰阳性菌感染率在逐年增高，有针对性地合理选用抗生素，谨慎使用有肾毒性药物，保护肾功能，减少侵入性置管，缩短住院天数，将有助于控制医院急诊科革兰阳性菌感染。
목적：탐토본원급진과병방혁란양성균감염환자적위험인소，위기방치제공과학의거。방법회고성분석본원급진과감염병례중103례혁란양성균감염정황。채용단인소분석화다인소Logistic회귀분석기위험인소。결과분리환자혈액、뇨액、담、담즙、천자액、분비액、농즙급상구인류액송검표본공1796빈，검출양성표본631빈，총균주배양검출양성솔위35.1％。분리출병원균공593주，기중혁란양성균169주。465례감염병례중유103례검획혁란양성균감염，점22.2％。다인소Logistic회귀분석발현，중심정맥치관、만성신공능불전、주원천수≥20 d시급진과혁란양성균감염적독립위험인소。결론의원급진과혁란양성균감염솔재축년증고，유침대성지합리선용항생소，근신사용유신독성약물，보호신공능，감소침입성치관，축단주원천수，장유조우공제의원급진과혁란양성균감염。
Objective Objectives To study the risk factors related to the infections by gram-positive bacteria and to discuss how to control .Methods A case control study was performed .Data of 103 cases of nosocomial infection caused by gram-positive bacte-ria were analyzed .As a control ,the 362 cases of nosocomial infection caused by other bacteria were selected at the same time .The uni-variate analysis and multivariate Logistic regression were used for statistics analysis .Results During the period of 3 years,1796 sam-ples were obtained,in which positive samples were 631(35.1%),and 593 strains were separated,among which G+bacteria were 169. There were totally 465 patients with the infections by gram-positive bacteria ( incidence rate was 22.2%) .Results from unconditioned Logistic regression analysis showed that the risk factors were the central venous catheterization ,the chronic kidney insufficiency and the length of hospital stay .Conclusion There was an obvious ascending trend of infection rate caused by gram-positive bacteria in emer-gency department .The drug resistant rate is high in G+strains.The effective strategies and measures ,the precautional use of renal toxici-ty drugs,the reduction of unnecessary central venous catheter indwelling and the decrease of the length of hospital stay can reduce the incidence rate of the infections .