目的 了解高龄住院患者院内肺部感染病原微生物的检出情况,探讨住院时间长短、患者意识状态等因素与院内肺部感染发生之间的关系.方法 对住院治疗的604例高龄患者进行院内肺部感染以及感染病原微生物调查,总结其发病规律并比较不同意识状态、住院时间的高龄患者院内肺部感染率.结果 604例高龄住院患者中74例确认发生院内肺部感染(12.3％);38例获得病原微生物感染中:铜绿假单胞菌感染11例,鲍曼/溶血不动杆菌感染8例,肺炎克雷伯菌感染7例,白色念珠菌5例、热带念珠菌2例,其他类型5例.患者入院时意识状态清醒者感染率为9.5％,而意识模糊者和昏迷者分别为23.0％和67.5％,后者院内感染率显著高于清醒患者(P＜0.05);住院时间短于1周患者院内肺部感染发生率为9.5％.结论 高龄患者院内肺部感染率较高,其中铜绿假单胞菌、鲍曼/溶血不动杆菌、肺炎克雷伯菌等革兰阴性菌为常见病原微生物;意识状态差、住院时间较长的患者院内肺部感染发生率较高,应引起医护人员的足够重视.%Objective To evaluate the impact of hospital stays and the state of consciousness on hospital acquired pneumonia. Methods A retrospective study including 604 elderly patients with pulmonary infection was performed. They were classified by different pathogenic bacteria,different consciousness states and the length of hospital stays. Results 74 cases of elderly patients were confirmed to get hospital acquired pneumonia of all the 609 patients. 38 cases were supported by the result of pathogenic microorganisms, including: Pseudomonas aeruginosa infection in 11 cases, Acinetobacter baumannii infection in 8 cases, Klebsiella pneumoniae infection in 7 cases, Candida Albicans in 5 cases, two cases of Candida tropicalis and five cases of other types. For the state of consciousness, the infection rate is 9. 5% of patients awake on admission, 23.0% and 67. 5% respectively for the state of confusion and coma. Conclusion Elderly patients are more easily to get hospital acquired pneumonia, the patients with poor state of consciousness and longer hospital stay were in a higher incidence to acquire nosocomial pulmonary infection.
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