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中华养生保健 ›› 2022, Vol. 40 ›› Issue (17): 18-20.

• 论著 • 上一篇    下一篇

混合血流感染的病原菌分布、临床特征及危险因素分析

李伟霞, 孙波, 戈宁宁   

  1. 济宁医学院附属医院检验科,山东 济宁,272029
  • 出版日期:2022-09-01 发布日期:2022-08-26
  • 作者简介:李伟霞(1982.8-),女,汉族,籍贯:河北省沧州市,硕士研究生,主治医师,研究方向:临床细菌感染及耐药机制研究。
  • 基金资助:
    济宁医学院教师扶持基金(JYFC2019FKJ133)

The Distribution, Clinical Characteristics and Risk Factors of Pathogenic Bacteria in Mixed Bloodstream Infection

LI Wei-xia SUN Bo GE Ning-ning   

  1. Department of Laboratory Medicine, Affiliated Hospital of Jining Medical University, Jining Shandong, 272029, China
  • Online:2022-09-01 Published:2022-08-26

摘要: 目的 研究成人混合血流感染的病原菌分布、临床特征和危险因素。方法 采用回顾性分析的研究方法,收集2018年11月~2021年8月期间成人混合血流感染住院患者作为病例组,对于病例组每一份病例,按照1:2配比,选择相同时期分别与该病例的各病原菌相同的两份单一血流感染病例与之配对,入选的单一血流感染病例即为对照组。分析病例组病原菌分布情况,比较两组患者临床资料,运用多因素条件Logistic回归对混合血流感染的危险因素进行分析。结果 共鉴定出38例混合血流感染病例,76株病原菌,占住院成人血流感染的2.9%;病原菌中革兰阴性杆菌54株,其中占比前两位是大肠埃希菌和肺炎克雷伯菌,革兰阳性菌以肠球菌为主,病原菌组合中一半是革兰阴性杆菌组合;实体恶性肿瘤[P=0.016,优势比(OR)=4.862]和胆道感染(P=0.032,OR=3.704)是混合血流感染的独立危险因素;与单一血流感染相比,混合血流感染更多应用抗菌药物联合治疗(P<0.05)。结论 实体恶性肿瘤和胆道感染是混合血流感染的独立危险因素,为临床医生识别混合血流感染风险的患者提供依据。

关键词: 混合血流感染, 病原菌, 危险因素, 临床特征

Abstract: Objective The purpose of this study is to investigate the distribution of pathogens, clinical characteristics and risk factors of polymicrobial bloodstream infections(PBSIs)in adult patients. Methods In a retrospctive matched case-control study design, all hospitalised adults with PBSIs from November 2018 to August 2021 were recruited. For each PBSI case, two patients with monomicrobial bloodstream infections(MBSIs)by pathogens and period were matched. All MBSIs cases matched composed the control group. The distribution of pathogens of the case group was analyzed. The clinical data of the two groups were compared. The multivariable analysis was performed using conditional logistic regression to determine the independent risk factors associated with PBSIs. Results Thirty-eight episodes of PBSI(2.9% of all adult bloodstream infections)and 76 pathogens were identified. The first two strains of fifty-four gram-negative bacill were escherichia coli and klebsiella pneumoniae. The majority of gram-positive bacteria were Enterococcus. Half of the pathogen combinations were the combination of gram-negative bacilli. Solid malignant tumor[P=0.016; odds ratio (OR)= 4.862]and biliary tract infections(P=0.032;OR=3.704)were independent risk factors for PBSIs. Patients with PBSIs had higher percentage of antibiotics combination therapy than patients with MBSIs(P<0.05). Conclusion Solid malignant tumor and biliary tract infections are independent risk factors for PBSIs. These provide a basis for clinicians to identify patients at risk of PBSIs.

Key words: polymicrobial bloodstream infections, pathogen, risk factor, clinical characteristic

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