Analysis of pathogenic bacteria distribution,risk factors and countermeasures of nosocomial infection in elderly patients in gastroenterology department

Abstract:

Objective To investigate the distribution of pathogenic bacteria，risk factors and countermeasures of nosocomial infection in elderly patients in gastroenterology department.Methods A total of 265 elderly patients admitted to the Gastroenterology Department，Chongqing Emergency Medical Center from May 2019 to October 2022 were selected as research objects. According to whether the patients had infection during hospitalization，they were divided into the infected group（n=87） and the non-infected group（n=178）. The infected sites of elderly patients with nosocomial infection in the department and the distribution of pathogenic bacteria after isolation and culture were observed. Binary logistic regression model was used to analyze the risk factors of nosocomial infection in elderly patients in the gastroenterology department.Results Among 265 elderly patients in the gastroenterology department，87 cases were infected，including 33 cases of respiratory tract infection，15 cases of urinary tract infection，20 cases of digestive system infection，13 cases of skin and soft tissue infection，and 6 cases of catheter-related bloodstream infection. And 87 strains of pathogenic bacteria were isolated from 87 elderly patients with nosocomial infection in the gastroenterology department by bacterial culture，including 28 strains of Gram-positive bacteria（32.18%），52 strains of Gram-negative bacteria（59.77%） and 7 strains of fungi（8.05%）. There was no significant difference in gender，course of disease，history of hypertension，smoking history，drinking history and BMI between the infected group and the non-infected group（P>0.05）. There were statistically significant differences in age，duration of antibiotic use，length of hospital stay，mechanical ventilation，diabetes，indignant catheter，hemoglobin，albumin，and indignant gastric tube（P<0.05）. Logistic regression analysis showed that age > 70 years old，duration of antibiotic use > 48 h， duration of hospital stay > 15 d，mechanical ventilation，diabetes，indignant catheter，hemoglobin < 90 g/L，albumin< 30 g/L and indignant gastric tube were independent risk factors for nosocomial infection in elderly patients in the gastroenterology department（P<0.05）.Conclusion Staphylococcus aureus，Acinetobacter baumannii and Pseudomonas aeruginosa dominate the pathogenic bacteria in elderly patients with nosocomial infections in the gastroenterology department，and the occurrence of nosocomial infections is related to age，antibiotic use time，hospital stay，mechanical ventilation，diabetes，indignant catheter，hemoglobin < 90 g/L，albumin < 30 g/L，indignant gastric tube and other factors. Clinical attention should be paid to reducing the incidence of nosocomial infection through relevant intervention measures.