Abstract：Objective To investigate the influencing factors of nosocomial infections among patients undergoing radiotherapy, so as to provide insights into nosocomial infection control among radiotherapy patients. Methods The malignant tumor patients receiving radiotherapy in Yiwu Central Hospital from 2019 to 2020 were selected. Their demographic features, radiotherapy and nosocomial infections were collected through the eletronic medical records. The factors affecting nosocomial infections were identified among radiotherapy patients using a multivariable logistic regression model. Results Totally 553 malignant tumor patients receiving radiotherapy were enrolled, including 268 men ( 48.46% ) and with a mean age of ( 60.31±13.66 ) years. The mean duration of hospital stay was ( 28.67±14.32 ) days, and the mean radiotherapy cycle was ( 3.63±1.89 ) weeks. A total of 46 patients were detected with nosocomial infections, with prevalence of 8.32%. The top three sites with the highest prevalence of nosocomial infections included the lower respiratory tract ( 14 cases, 30.43% ), oral cavity ( 10 cases, 21.74 ) and urinary tract ( 8 cases, 17.39% ), and 42 bacterial strains were isolated, with Gram-negative bacteria as the predominant strains ( 25 strains, 59.52% ). Multivariable logistic regression analysis showed that radiotherapy cycle of 4 weeks and longer ( OR=3.857, 95%CI: 1.896-7.846 ), radiotherapy exposure ( OR=3.254, 95%CI: 1.561-6.783 ), arteriovenous catheterization ( OR=2.165, 95%CI: 1.144-4.098 ), urinary tract intubation ( OR=6.028, 95%CI: 1.841-19.734 ) and poor nutritional status ( OR=3.933, 95%CI: 1.493-10.360 ) were associated with nosocomial infections among radiotherapy patients. Conclusion Radiotherapy cycle, exposure to radiotherapy, arteriovenous catheterization, urinary tract intubation and poor nutritional status are factors affecting nosocomial infections among radiotherapy patients.
[1] QIU H B,CAO S M,XU R H.Cancer incidence,mortality,and burden in China:a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020[J].Cancer Commun,2021,41(10):1037-1048. [2] WANG Z H,TANG Y,TAN Y N,et al.Cancer-associated fibroblasts in radiotherapy:challenges and new opportunities[J].Cell Commun Signal,2019,17(1):47-58. [3] 于新平,吴玉梅.宫颈癌放射治疗敏感性的相关影响因素[J].肿瘤学杂志,2017,23(7):631-635. YU X P,WU Y M.Factors associated with radiosensitivity of cervical cancer[J].J Chin Oncol,2017,23(7):631-635. [4] ZHAO M,LIU W G,ZHANG L,et al.Can axillary radiotherapy replace axillary dissection for patients with positive sentinel nodes?A systematic review and meta-analysis[J].Chronic Dis Transl Med,2017,81(5):341-320. [5] 中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320. Ministry of Health of the People's Republic of China.Diagnostic criteria for nosocomial infections(proposed)[J].Chin Med J,2001,81(5):314-320. [6] KONDRUP J,RASMUSSEN H H,HAMBERG O,et al.Nutritional risk screening(NRS 2002):a new method based on an analysis of controlled clinical trials[J].Clin Nutr,2003,22(3):321-336. [7] 蔡陈枫,朱六玲,徐胜,等.放疗科住院患者的医院感染特点分析[J].中国卫生产业,2017,14(18):163-164,167. CAI C F,ZHU L L,XU S,et al.Analysis of hospital infection features of inpatients in the department of radiotherapy[J].China Health Ind,2017,14(18):163-164,167. [8] 郭仲卿,安星,杨越.肿瘤患者放疗后医院感染的危险因素分析[J].实用临床医药杂志,2019,23(8):81-84. GUO Z Q,AN X,YANG Y.Analysis on risk factors of noscomial infection following radiotherapy in tumor patients[J].J Clin Med Pract,2019,23(8):81-84. [9] 周雪,叶英,孙秋林,等.某三甲肿瘤医院2013—2017年医院感染现患率调查分析[J].中国现代医学杂志,2019,29(23):52-57. ZHOU X,YE Y,SUN Q L,et al.Prevalence rates of healthcare-associated infection in a major cancer hospital from 2013 to 2017[J].China J Mod Med,2019,29(23):52-57. [10] 郑慧,张晓红,郑珊红.肿瘤医院2010—2014年医院感染现患率调查[J].中国感染控制杂志,2017,16(6):568-570. ZHENG H,ZHANG X H,ZHENG S H.Prevalence rates of healthcare-associated infection in a tumor hospital in 2010-2014[J].Chin J Infect Control,2017,16(6):568-570. [11] 张刚,曹文成,林芳,等.某肿瘤专科医院2016—2018年医院感染横断面调查[J].中国消毒学杂志,2020,37(21):938-944. ZHANG G,CAO W C,LIN F,et al.Cross-sectional investigation of nosocomial infections in a cancer hospital from 2016 to 2018[J].Chin J Disinfect,2020,37(21):938-944. [12] CHEN Y,ZHAO J Y,SHAN X,et al.A point-prevalence survey of healthcare-associated infection in fifty-two Chinese hospitals[J].J Hosp Infect,2017,95(1):105-111. [13] MAGDALENA J B,RYSZARD S,TOMASZ C T,et al.Microenvironment as a“game changer”in cancer radiotherapy[J].Int J Mol Sci,2019,20(13):3212-3230. [14] 刘艳平,何泳红,邓颖辉.恶性肿瘤患者医院感染病原菌分布及危险因素分析[J].中国消毒学杂志,2019,36(2):124-127. LIU Y P,HE Y H,DENG Y H.Distribution of pathogenic bacteria and analysis on risk factors of infection in patients with malignant tumor[J].Chin J Disinfect,2019,36(2):124-127. [15] 姜立经,高海蓉,徐蓓,等.恶性肿瘤患者及其主要照顾人健康教育需求调查[J].预防医学,2021,33(1):97-100. JIANG L J,GAO H R,XU B,et al.Health education demand of the patients with cancer and their caregivers[J].Prev Med,2021,33(1):97-100.
