Abstract:Objective To analyze the clinical characteristics and risk factors of nosocomial infection in hospitalized patients in orthopedic department,so as to provide scientific basis for reducing the incidence of nosocomial infection in orthopedic.Methods A total of 3542patientswho hospitalized in the orthopedic department from September 1,2017 to August 31,2018 in our hospital were selected as themonitoring objects and divided into three specialized groups:the trauma group(1295cases),the joint group(1075cases)and the spine group(1172cases).The clinical characteristics and risk factors of nosocomial infection in orthopedic inpatientswere analyzed.Results The incidence rate of nosocomial infection of orthopedic inpatientswas 1.67% (the case number infection ratewas 1.89%).The incidence rate of case number nosocomial infection in the trauma group was 2.93%,which was higher than that in the joint group(1.58%)and spine group(1.02%),the differenceswere statistically significant(P<0.05).The top three infection siteswere lower respiratory tract(32.84%),surgical site(31.34%)and urinary tract(20.90%).Gram-negative bacteria,gram-positive bacteria and fungi accounted for 50.00%,46.00%,and 4.00%,respectively.The top three pathogens were Staphylococcus aureus(24.00%),Escherichia coli(20.00%)and Acinetobacter baumannii(12.00%).The differences between the infected and uninfected patients in age(over 65years old),gender,hypoproteinemia,basic diseases(more than 2kinds),traction brake,surgery,use of ventilator,admission to ICU,central vein catheterization and indwelling catheter were statistically significant(P<0.05).Furthermultivariate unconditional Logistic regression analysis showed thatmale,hypoproteinemia,basic diseases (more than 2kinds),admission to ICU,central vein catheterization and indwelling catheter were independent risk factors of nosocomial infection in orthopedic patients(P<0.05).Conclusion The nosocomial infection of orthopedic inpatients has the following characteristics:themainly infection sites are lower respiratory tract and surgical site,the proportion of gramnegative bacteria and gram-positive bacteria is similar,and the nosocomial infection rate in trauma patients is higher.The risk of nosocomial infection of orthopedic inpatients with one ormore of the above risk factors is higher.The hypoproteinemia and basic diseases should be actively treated,and invasive operation should be standardized and reduced,in order to reduce the nosocomial infection rate.
Spatenkova V,Bradac O,Fackova D,et al.Low incidence of multidrug-resistant bacteria and nosocomial infection due to a preventivemultimodal nosocomial infection control:a 10-year single centre prospective cohort study in neurocritical care[J].BMC Neurol,2018,18(1):23.
Rosenthal VD,Rodrigues C,Alvarez-Moreno C,et al.Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in adult intensive care units from 14developing countries of four continents:Findings of the International Nosocomial Infection Control Consortium[J].Crit Care Med,2012,40(12):3121-3128.
Durand F,Berthelot P,Cazorla C,et al.Smoking is a risk factor of organ/space surgical site infection in orthopaedic surgery with implantmaterials[J].Int Orthop,2013,37(4):723-727.
Zhang J,Zhao T,Long S,et al.Risk factors for postoperative infection in Chinese lung cancer patients:A metaanalysis[J].JEvid Based Med,2017,10(4),255-262.
[20]
Bohl DD,Saltzman BM,Sershon RA,et al.Incidence,risk factors,and clinical implications of pneumonia following total hip and knee arthroplasty[J].JArthroplasty,2017,32(6):1991-1995.