泌尿道来源大肠埃希菌继发血流感染的危险因素分析

摘要

Objective To investigate the secondary bloodstream infections of hospital patients infected by Escherichia coli from urinary tract ;and study the risk factors of secondary bloodstream infections caused by Esche‐richia coli from urinary tract and its isolated rate change .To provide a reasonable scientific evidence for hospital′s preventing and controlling of bloodstream infections by Escherichia coli .Methods Collect test group samples and the same number of negative group samples of secondary bloodstream infections caused by Escherichia coli from urinary tract from 2011-2013 .Use the software of SPSS 17 .0 to analyze the results by univariate chi‐square test and multi‐variate Logistic regression analysis .Calculate the isolated rate for each year and each department in 2011-2013 .Ana‐lyze the Changes of isolation rate by tables and histograms .Results Renal insufficiency(P<0 .05) ,urinary catheters (P<0 .05) ,fever(P<0 .05)and urine leukocytosis(P<0 .05)was statistically significant in the experimental group and negative group ,which are risk factors .Wherein the urinary catheter ,fever and urine leukocytosis have a more sig‐nificant relationship ,which are independent risk factors .Conclusion Secondary bloodstream infections caused by Escherichia coli from urinary tract is the result of multiple factors ,mainly related to the urinary catheter ,fever and u‐rine leukocytosis .For patients with these risk factors should minimize invasive procedures such as urinary catheteriza‐tion ,strict aseptic and disinfection system ;pay close attention to the clinical symptoms and laboratory indexes .The phenomenon of secondary bloodstream infections caused by Escherichia coli from urinary tract has a significantly in‐creased and spread trend in the hospital by analyzing the tables and histograms of isolated rate .%目的：了解住院患者泌尿道来源大肠埃希菌（ECO ）继发血流感染情况，探讨泌尿道来源ECO继发血流感染的危险因素及此种现象的分离率变迁情况，为更好地预防和控制泌尿道来源ECO继发血流感染和流行提供科学依据。方法收集2011～2013年由泌尿道来源ECO继发血流感染的住院患者82例，与同期尿培养为 ECO但无血流感染患者82例进行单因素χ2检验及多因素Logistic回归分析。分别计算2011～2013年各年及不同科室泌尿道来源EC O的分离率，绘制成表格进行分析得出分离率变迁情况。结果肾功能不全、尿管留置、发热、尿常规白细胞增多在试验组和阴性组中差异具有统计学意义（P＜0．05），属于危险因素。其中尿管留置、发热、尿常规白细胞增多具有显著关系，属于独立危险因素。结论泌尿道来源ECO继发血流感染为多因素所致，主要与尿管留置、发热、尿常规白细胞增多有关，对存在上述危险因素的患者应尽量减少侵入性操作（如泌尿插管等），严格无菌及消毒制度，密切关注临床症状及其实验室检查指标。通过分离率的图表发现，泌尿道来源ECO继发血流感染的现象明显升高，并在该院呈扩散趋势。