医院内血流感染病原学分布及危险因素分析  

Clinical analysis of etiology distribution and risk factors for nosocomial bloodstream infection

作　　者：臧奎[1] 尚福泰[1] 郭世光[1] 惠亮亮[1] 刘蓉[2] 张劲松[2] 

机构地区：[1]南京医科大学附属淮安第一医院重症医学科,江苏省223300 [2]南京医科大学第一附属医院急诊科

出　　处：《江苏医药》2015年第19期2277-2279,共3页Jiangsu Medical Journal

摘　　要：目的分析住院患者血流感染的病原学分布及影响预后的危险因素。方法回顾性分析住院患者血流感染161例的资料。入组患者随访90d,死亡49例(死亡组)和存活112例(存活组)。分析影响住院患者血流感染死亡的危险因素。结果院内血流感染最常见菌株:大肠埃希菌28株(16.7%),金黄色葡萄球菌26株(15.5%),肺炎克雷伯杆菌16株(9.5%),不动杆菌属12株(7.1%)。入住ICU是影响血流感染住院患者预后的独立危险因素(OR=1.14,P<0.05)。急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)<13分的血流感染住院患者生存时间长于APACHEⅡ≥13分的患者(P<0.01)。结论院内血流感染最常见的病原菌为大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯杆菌和不动杆菌属。入住ICU和APACHEⅡ≥13分是影响院内血流感染患者90d生存率的重要危险因素。Objective To analyze the etiology distribution and risk factors for nosocomial bloodstream infection .Methods Data of 161 patients with nosocomial bloodstream infection were retrospectively analyzed .The patients were followed up for 90 days and divided into two groups of A （died ,49 cases ） and B （survial ,112 cases ） .The factors influencing death of the patients with nosocomial bloodstream infection were analyzed .Results The most four common strains of nosocomial bloodstream infections were E . coli （28 strains ,16.7% ） , Staphylococcus aureus （26 strains ,15.5% ） ,Klebsiella pneumoniae（16 strains ,9.5% ） ,Acinetobacter（12 strains ,7.1% ） . Hospitalizing ICU was an independent risk factor influencing the prognosis of the patients with nosocomial bloodstream infection（OR=1 .14 ,P〈0 .05） .The survival time was longer in the cases with acute physiology and chronic health evaluationⅡ （APACHEⅡ ） score 〈13 points than that in those with APACHIE Ⅱ ≥ 13 points （ P〈0 .01 ） .Conclusion The most four common strains of nosocomial bloodstream infections are E .coli ,Staphylococcus aureus ,K lebsiella pneumonia and Acinetobacter .Hospitalizing ICU and APACHIEⅡ score≥13 points are the risk factors influencing the 90‐d survival rate in the patients with nosocomial bloodstream infection .

关 键 词：医院内感染 病原学分布 

分 类 号：R372[医药卫生—病原生物学]