Analysis Of Related Factors Of Nosocomial Infection In Patients With Acute Myocardial Infarction After Interventional Therapy

Objective To examine the pathogen distribution,risk factors of nosocomial infection and changes in levels of relevant factors in patients receiving interventional therapy for acute myocardial infarction.Methods Subjects were patients who underwent emergency coronary intervention for acute myocardial infarction from July 2016-May 2018 at this hospital.Fifty-tow of those patients had a nosocomial infection while 49 did not.The site of infection and pathogens causing an infection during hospitalization were analyzed retrospectively.The clinical data of patients’ age,basic diseases and length of stay were collected to analyze their correlation with the occurrence of nosocomial infection.Blood samples were collected from the two groups of patients on admission and the third day after interventional therapy,and serum was separated.Hs-CRP was detected by immunoturbidimetry,PCT was detected by double anti sandwich immunochemiluminescence method,fluorescence immunoassay was used to detect BNP,and then compared and analyzed.Results In the 52 patients with a nosocomial infection,the site of infection was mainly the respiratory system(37 patients,71.15%).One hundred and ninety-six strains of pathogenic bacteria were isolated.Of those,152(77.55%)were strains of Gram-negative bacteria and 44(22.45%)were strains of Gram-positive bacteria.Univariate analysis indicated that age(>50 years of age),duration of hospitalization(>15 days),grade of cardiac function(>III),underlying illness,invasive surgery,and serum albumin(<30g/L)were related to a higher incidence of a nosocomial infection(P<0.05).Hs-crp,PCT and BNP levels were measured at admission and on the third day after the intervention,and the infection group at admission was compared with the control group,hs-CRP(7.80 ± 3.99)mg/L vs(7.82±3.14)mg/L(P=0.988);PCT(0.04±0.03)μg/L vs(0.05±0.03)μg/L(P=0.109);BNP(207.19±184.30)ng/L vs(263.71±346.40)ng/L(P=0.305).There was no statistically significant difference between the infection group and the control group.Comparison of infection group and control group on the third day after intervention,hs-CRP(68.73±18.71)mg/L vs(8.1431±2.61)mg/L(P<0.001);PCT(0.44±0.25)μg/L vs(0.04±0.02)μg/L(P<0.001);BNP(309.03±185.43)ng/L vs(220.06±143.15)ng/L(P=0.008).On the third day after the intervention,the infection level of the two groups was significantly higher than that of the control group,and the difference between the two groups was statistically significant.Conclusions Nosocomial infections in patients undergoing interventional therapy for acute myocardial infarction are mainly concentrated in the respiratory system.Gram-negative bacteria are the main pathogens responsible.The increased risk of a nosocomial infections is closely related to age,a long duration of hospitalization,a high grade of cardiac function,underlying illness,invasive surgery,and malnutrition.Levels of inflammatory factors and BNP were higher in patients with a nosocomial infection.Determining the site of infection and the distribution of pathogenic bacteria,ascertaining related risk factors,and detecting the levels of relevant factors are crucial to preventing and controlling nosocomial infections in patients receiving interventional therapy.