西安市鄠邑区老年患者血源性感染凝固酶阴性葡萄球菌的分布及耐药性分析

摘要/Abstract

摘要： 目的调查与分析西安市鄠邑区老年患者血源性感染凝固酶阴性葡萄球菌（Coagulase-Negative Staphylococcus,CoNS）的分布及耐药性情况。方法选择2019年10月—2022年12月在西安市鄠邑区中医医院进行诊治的鄠邑区686例老年患者作为研究对象,判定血源性感染情况,分离凝固酶阴性葡萄球菌并进行耐药性分析,调查所有患者的临床资料,采用Logistic多因素分析老年患者血源性感染的影响因素。结果在686例患者中,发生医院血源性感染82例,占11.95%,共分离到病原体100株,其中革兰氏阳性细菌65株（包括凝固酶阴性葡萄球菌20株）,革兰氏阴性杆菌35株。在凝固酶阴性葡萄球菌中,对利奈唑胺、青霉素、左氧氟沙星、环丙沙星的耐药率都超过了90.00%,对万古霉素、替加环素的耐药率都为0.00%,对庆大霉素、利福平的耐药率分别为60.00%和15.00%。二分类Logistic回归分析显示,糖尿病（β=1.482,OR=3.581,P<0.001）、低蛋白血症（β=3.113,OR=3.117,P<0.001）、重症监护病房住院时间（β=2.478,OR=2.841,P<0.001）、放置引流管（β=2.988,OR=1.893,P<0.001）等为导致医院血流感染发生的重要因素（P<0.05）。结论西安市鄠邑区重症监护病房老年患者的血源性感染发生率比较高,凝固酶阴性葡萄球菌的占比比较高,具有广泛的耐药性,糖尿病、低蛋白血症、重症监护病房住院时间、放置引流管等为导致血源性感染发生的重要因素。

关键词: 老年, 重症监护病房, 血源性感染, 凝固酶阴性葡萄球菌, 耐药性

Abstract: Objective To investigate and analyis the distribution and drug resistance of Coagulase-Negative Staphylococcus (CoNS) in elderly patients with blood-borne infection in Xi 'an HuYi District. Methods 686 cases of Xi 'an HuYi District patients in a certain area who were diagnosed and treated in the intensive care unit of Xi'an HuYi District Hospital of Traditional Chinese Medicine from October 2019 to December 2022 were selected as the study subjects, and the condition of blood-borne infection were determined, coagulase-negative staphylococci were isolated and drug resistance analysis were performed, and the general data of all patients were investigated and the influencing factors were analyzed. Results In the 686 patients, there were 82 cases (11.95%) of nosocomial blood-borne infection occurred. A total of 100 strains of pathogens were isolated, included 65 strains of gram-positive bacteria (included 20 strains of coagulase-negative staphylococcus) and 35 strains of gram-negative bacteria. In the strains of coagulase-negative Staphylococcus, the drug resistance rates to linezolid,penicillin, levofloxacin and ciprofloxacin were all exceeded 90.00%, the drug resistance rates to vancomycin and tegacyclin were all 0.00%, and the drug resistance rates to gentamicin and rifampicin were 60.00% and 15.00% respectively. The binary logistic regression analysis showed diabetes (β=1.482, OR=3.581, P<0.001), hypoproteinemia (β=3.113, OR = 3.117, P<0.001), intensive care unit stay (β=2.478, OR=2.841, P<0.001), drain placement (β=2.988, OR=1.893, P<0.001) as important factors of nosocomial bloodstream infection (P<0.05). Conclusion The incidence of blood borne infection in elderly ICU patients in Xi 'an HuYi District is relatively high, the proportion of coagulase negative staphylococci is relatively high, and they have extensive drug resistance. diabetes, hypoproteinemia, length of stay in intensive care unit, placement of drainage tubes, etc. are important factors leading to the occurrence of blood borne infection.

Key words: old age, intensive care unit, bloodborne infection, coagulase negative staphylococcus, drug resistance

中图分类号:

R446.5

杨朝勃. 西安市鄠邑区老年患者血源性感染凝固酶阴性葡萄球菌的分布及耐药性分析[J]. 中华养生保健, 2023, 41(21): 89-93.

YANG Chao-bo. Distribution and Drug Resistance Analysis of Coagulase-Negative Staphylococcus in Elderly Patients with Blood-Borne Infection in Xi'an HuYi District[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(21): 89-93.

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