Analysis and prevention strategies of nosocomial infection cases in obstetric ward
产科病房发生院内感染病例的分析及防控策略研究

摘要

目的 调查和分析我院产科病房发生院内感染的特点、危险因素，采取相应措施，以降低孕产妇院内感染的发生率。方法 采用回顾性分析，调查2024年1月至2024年12月在我院住院孕产妇4383例的临床资料，统计院内感染发生率、感染发生类型、病原体分布及耐药性，通过Logistic回归对发生院内感染病例患者的相关原因进行分析。结果 4383例产科住院患者中，其中医院感染者26例，感染率为0.59%；感染部位以生殖道感染为主，共20例，占76.92%；其次为上呼吸道感染，共6例，占23.07%，生殖道感染病原体以大肠埃希菌、粪肠球菌为主。Logistic回归多因素分析结果显示，分娩方式、是否球囊引产、妊娠并发症、产程延长、缝合技术、侵入操作、住院时间、阴道检查次数为产科发生医院感染的独立危险因素（P＜0.05）。结论 产科医院感染的发生与分娩方式、球囊引产、妊娠合并症、抗菌素的应用等多方面有关，应加强医务人员防感染管理，提高防感染意识，应合理规范抗生素应用，严格掌握剖宫产指征，积极治疗妊娠合并症。

Abstract

Objective To investigate and analyze the characteristics and risk factors of nosocomial infections in the obstetrics ward of our hospital, and to implement corresponding measures to reduce the incidence of nosocomial infections in pregnant women.
Methods A retrospective analysis was conducted on clinical data of 4,383 hospitalized pregnant women from January to December 2024. The study statistically analyzed the incidence rate of nosocomial infections, types of infections, distribution of pathogens, and drug resistance. Logistic regression was used to analyze the contributing factors of nosocomial infections.
Results Among 4,383 obstetric inpatients, 26 cases (0.59%) were nosocomial infections. The most common infection site was the reproductive tract (20 cases, 76.92%), followed by upper respiratory tract infections (6 cases, 23.07%). Pathogens in reproductive tract infections were primarily Escherichia coli and Enterococcus faecalis. Multivariate logistic regression analysis revealed that delivery method, balloon-assisted induction, pregnancy complications, prolonged labor, suturing techniques, invasive procedures, hospitalization duration, and vaginal examination frequency were independent risk factors for nosocomial infections in obstetrics (P<0.05).
Conclusion   Obstetric nosocomial infections are associated with multiple factors including delivery methods, balloon-assisted induction, pregnancy complications, and antibiotic use. Strengthening infection control management among medical staff, enhancing infection prevention awareness, standardizing antibiotic application, strictly controlling cesarean section indications, and actively treating pregnancy complications are essential.