肾内科患者院内感染病原菌分布及相关因素分析  

Distribution of pathogens infecting patients in Nephrology and an analysis of related factors

作　　者：王世英[1] 杨素霞[1] 时军[1] 

机构地区：[1]河南大学淮河医院肾内科,河南开封475000

出　　处：《中国病原生物学杂志》2017年第4期363-365,369,共4页Journal of Pathogen Biology

摘　　要：目的分析肾内科患者院内感染病原菌分布情况及相关因素,为患者临床感染的预防和治疗提供指导。方法收集315例肾内科住院患者临床资料,检测不同类型疾病患者感染情况及其在患者部位中的分布情况。分离并鉴定感染病原菌类型,并分析感染发生的相关因素。结果 315例住院患者中59例患者发生了院内感染,发生率18.73%。系统性红斑狼疮患者、肾病综合征患者、尿毒症患者以及其他肾病患者感染发生率分别为46.15%、26.32%、22.39%和11.96%。呼吸道和肺部感染占57.63%,尿路占18.64%,皮肤占13.56%,口腔占6.78%,肠道占3.39%。59例患者中有48例发生单一感染,11例发生多重感染。分离出病原菌74株,其中革兰阴性菌44株,革兰阳性菌28株,真菌2株。44株革兰阴性菌中大肠埃希菌23株,肺炎克雷伯菌7株,鲍曼不动杆菌6株,铜绿假单胞菌3株,其他革兰阴性菌5株;28株革兰阳性菌中粪肠球菌13株,屎肠球菌7株,金黄色葡萄球菌4株,表皮葡萄球菌2株,其他革兰阳性菌2株。患者的性别、年龄、住院时间、合并基础疾病以及有无侵入性操作等因素与院内感染的发生显著相关。结论肾内科系统性红斑狼疮患者发生院内感染的几率较高,感染部位以呼吸道和肺部为主,感染病原菌类型则以革兰阴性菌为主;患者合并基础疾病以及接受侵入性操作与患者感染发生关系密切。Objective To analyze the distribution of pathogens in patients in Renal Medicine in this Hospital and relat- ed factors to guide the prevention and treatment of clinical infections in patients. Methods Clinical data on 315 patients in Renal Medicine were collected, and the infection status of patients with different diseases and the site of infection were determined. Pathogens were isolated and identified, and factors related to infection were analyzed. Results Of the 315 inpatients, 59 developed an infection, for a rate of infection of 18.73%. The rate of infection in patients with systemic lu- pus erythematosus was 46.15%, the rate in patients with nephrotic syndrome was 26.32%, the rate in patients with ure- mia was 22.39%, and the rate in patients with some other type of kidney disease was 11. 96%. The site of infection was the respiratory tract and lungs in 57.63% of patients, the urinary tract in 18.64%, the skin in 13.56%, the mouth in 6. 78%, and the intestines in 3.39%. Forty--eight patients had a single infection while 11 had a combined infection. Seven ty--four strains of pathogens were isolated, including 44 strains of Gram--negative bacteria, 28 strains of Gram positive bacteria, and 2 strains of fungi. The 44 strains of Gram--negative bacteria included 23 strains of Escherichia coli, 7 strains of Klebsiella pneumoniae, 6 strains of Acinetobacter baumannii, 3 strains of Pseudomonas aeruginosa, and 5 strains of other spp. The 28 strains of Gram--positive bacteria included 13 strains of Enterococcus faecalis, 7 strains of E. faecium, 4 strains of Staphylococcus aureus, 2 strains of S. epidermis, and 2 strains of other spp. Gender, age, du- ration of hospitalization, and comorbidities were closely correlated with whether or not the patient was able to undergo in- vasive surgery and whether or not the patient developed a nosocomial infection. Conchtsion Patients with systemic lu- pus erythematosus had the highest rate of infection, and the site of infection was predominantly the respiratory tract and lun

关 键 词：肾内科 感染 相关因素 

分 类 号：R378[医药卫生—病原生物学]