Nosocomial infections and chronic severe hepatitis B: A clinical study of 162 patients
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摘要: 目的分析总结慢性乙型重型肝炎患者发生医院感染的特点,为加强医院感染的防控提供帮助。方法调查分析我院2008年1月至2011年10月收治的慢性乙型重型肝炎患者162例发生医院感染的情况。结果 162例慢性乙型重型肝炎患者中发生医院感染35例,医院感染率为21.6%。感染部位以腹腔感染和呼吸道感染最多,其次为肠道感染。病原菌以大肠埃希菌和肺炎克雷伯杆菌常见。医院感染主要发生在住院时间15~30 d,占72.09%。医院感染组治疗无效率(20%)显著高于非医院感染组(7.09%)(P<0.05)。结论慢性乙型重型肝炎医院感染发生率高,应积极治疗原发病,改善肝功能,严格遵守消毒隔离制度,加强医院感染的防控,从而提高生存率。Abstract: Objective To analyze and summarize the characteristics of nosocomial (hospital-acquired) infections experienced by chronic severe hepatitis B patients in order to strengthen prevention and control strategies.Methods Chronic severe hepatitis B patients treated in our hospital from January 2008 to October 2011 were retrospectively enrolled in the study.Cases of nosocomial infections were statistically analyzed by the Chi-squared test.Results Of the 162 patients with chronic severe hepatitis B, only 35 experienced nosocomial infections, yielding an infection rate of 21.6%.The most common infection sites were the abdominal cavity (41.86%) , the respiratory system (23.26%) , and the intestine (16.28%) .Escherichia coli and Klebsiella pneumoniae were the most commonly detected pathogens (29.63% and 18.52% of cases, respectively) .The rates of nosocomial infections were highest between days 15 to 30 of the hospital stay, accounting for 72.1%.The overall invalid rate and rate of death (expressed as a summed rate of ineffectivity) was significantly higher in the nosocomial infection group than in the non-nosocomial group (20.0% vs 7.1%, respectively;P<0.05) .Conclusion The rate of nosocomial infections in chronic severe hepatitis B patients is high.Patients with chronic severe hepatitis B should be treated to resolve the primary disease, so as to improve liver function and general health;however, strict compliance with disinfection and hygeinic practices, as well as possible patient isolation, may decrease the incidence rate of nosocomial infections and improve survival in this patient population.
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Key words:
- hepatitis B /
- chronic
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[1]中华医学会传染病与寄生虫学分会、肝病学分会.病毒性肝炎防治方案[J].中华肝脏病杂志, 2000, 8 (6) :324-329. [2]中华人民共和国卫生部.医院感染诊断标准 (试行) [J].中华医学杂志, 2001, 81 (5) :314-320. [3]陈建春.本院近6年重型病毒性肝炎患者的医院感染调查[J].医学信息, 2007, 20 (6) :977-988.
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