抑郁症住院患者院内感染情况调查及其影响因素分析

周婧琪 朱芹汶 姚树永 刘威 张方明 曹敏娟

[摘要]目的探討抑郁症住院患者院内感染情况及其相关影响因素。方法选取2018年1月至2020年6月于苏州市广济医院接受住院治疗的2606例抑郁症患者为研究对象，根据有无发生院内感染将其分为感染组112例和非感染组2494例，采集其社会人口学资料、临床资料等，对其院内感染情况进行调查，并对其相关影响因素进行分析。结果抑郁症住院患者发生院内感染112例，感染组例次数117例，培养分离出病原菌38例，其中革兰阳性菌19例，革兰阴性菌16例，真菌3例。抗菌药物的使用以非限制使用级、口服、单药为主，用药目的以治疗为主。经过 logistic 回归分析，女性、年龄≥60岁、住院天数≥30 d、重度抑郁、使用抗抑郁药≥2种、糖尿病、合并躯体疾病（除糖尿病）、ALB <35 g/L、进行保护性约束和 MECT 是抑郁症住院患者院内感染的独立危险因素（ P <0.05）。结论应根据医院感染的相关因素，对患者实行个体化监护，以降低抑郁症住院患者院内感染的发生率。

[关键词]抑郁症;院内感染;感染情况;影响因素

[中图分类号] R749.4  [文献标识码] A   [文章编号]2095-0616（2021）24-0173-06

An investigation of nosocomial infection among the inpatients with depression and the analysis of its influencing factors

ZHOUJingqi1ZHUQinwen2YAOShuyong1LIUWei1ZHANGFangming1CAOMinjuan1

1.Pharmacy Department， Suzhou Guangji Hospital， Jiangsu， Suzhou 215000， China;2. Pharmacy Department， Suzhou Kowloon Hospital Affiliated to School of Medicine of Shanghai Jiao Tong University， Jiangsu， Suzhou 215000， China [Abstract] Objective To probe into the nosocomial infection among the inpatients with depression and the related influencing factors. Methods A total of 2606 patients with depression who were hospitalized in Suzhou Guangji Hospital from January 2018 to June 2020 were taken as the subjects of research. They were divided into the infection group （n=112） and the non-infection group （n=2494） according to whether there was nosocomial infection. The social demographic data and clinical data were collected， the nosocomial infection was investigated， and the related influencing factors were analyzed. Results There were 112 cases of nosocomial infection among the inpatients with depression， with 117 times of the infection.38 cases of pathogenic bacteria were isolated by culture， including 19 cases of Gram-positive bacteria， 16 cases of Gram-negative bacteria and 3 cases of fungi. The use of antibiotics is mainly non-restricted， oral and single drug The medication was mainly for the sake of treatment. According to logistic regression analysis， the independent risk factors of the nosocomial infection of the inpatients with depression included being female， the age ≥60 years old， the hospitalization days ≥30 d， severe depression， the kinds of antidepressants used ≥2， diabetes mellitus （DM）， concomitant somatic diseases （except DM）， ALB <35 g/L， protective restraint and MECT （P <0.05）. Conclusion Individualized monitoring should be carried out according to the related factors of nosocomial infection in order to reduce the incidence of nosocomial infection among the inpatients with depression.

[Key words] Depression; Nosocomial infection; Infection; Influencing factor

抑郁障碍是最常见的精神障碍之一，以心境持续低落为主要临床表现，严重者会出现幻觉、妄想等精神病性症状，部分患者甚至会出现自伤、自杀的行为[1]。目前院内感染是住院患者最常见的并发症之一[2]，在一定程度上，院内感染会加重患者的抑郁程度，形成恶性循环[3-4]。因此，对抑郁症患者院内感染危险因素的研究具有重要意义。本研究对抑郁症住院患者院内感染的情况进行调查分析，并进一步从人口统计学、临床特征、药物治疗相关因素、家庭因素等多个方面综合全面地分析影响院内感染的因素，以期为临床个体化监护患者奠定理论基础，减少患者院内感染的风险，为减轻患者家庭和社会负担做出贡献。……