带状疱疹后遗神经痛患者继发感染病原菌特点及相关影响因素分析  

Characteristics of pathogenic bacteria and influencing factors analysis of secondary infections in patients with postherpetic neuralgia

作　　者：丁伟民[1] 吴玮 郑旺福[1] 丁雷鸣[1] 吴丹[1] 应锦河[1] 许丽华[2] 

机构地区：[1]浙江省丽水市中心医院麻醉科,浙江丽水323000 [2]台州市第一人民医院麻醉科,浙江台州318020

出　　处：《中华医院感染学杂志》2017年第22期5137-5140,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生一般研究基金资助项目(2014KYA232)

摘　　要：目的探讨带状疱疹后遗神经痛继发感染患者的病原菌特点及相关影响因素。方法选择医院于2015年1月-2016年12月期间收治的带状疱疹后遗神经痛患者986例,分析带状疱疹后遗神经痛继发感染病原菌分布特点和耐药性,对患者继发感染的发生率及相关因素进行观察和分析。结果发生继发感染患者91例,感染率为9.23%;共检出病原菌82株,以革兰阴性菌为主,共55株占67.07%;革兰阳性菌对红霉素、环丙沙星、青霉素耐药率较高,革兰阴性菌对阿米卡星、美罗培南、亚胺培南耐药率较高;logistic多因素回归分析结果显示,皮损严重、皮损面积>5%、初治时间≥3d为带状疱疹后遗神经痛继发感染独立危险因素(P<0.05)。结论根据带状疱疹后遗神经痛继发感染病原菌特点进行针对性治疗,且对其危险因素采取积极有效的预防措施,降低其发病。OBJECTIVE To explore the characteristics of pathogenic bacteria and influencing factors analysis of sec-ondary infections in patients with postherpetic neuralgia.METHODS A total of 986 patients with postherpetic neu-ralgia treated in the hospital from Jan.2015 to Dec.2016 were selected.The distribution of pathogens and drug resistance of the secondary infections of herpes zoster were analyzed,the incidence and related factors of secondary infections were observed and analyzed.RESULTS In 986 cases of postherpetic neuralgia,91 cases had secondary infection,and the infection rate was 9.23%.Totally 82 strains of pathogenic bacteria were detected,which were mainly 55 strains of gram-negative bacteria,accounting for 67.07%.The gram-positive bacteria had high resistant rates to erythromycin,ciprofloxacin and penicillin,and gram-negative bacteria had high resistant rates to amika-cin,meropenem and imipenem.Logistic multivariate regression analysis showed that,severe lesions,lesion area〉5%,and the initial treatment time ≥3 d were independent risk factors of secondary infections of postherpetic neuralgia（P〈0.05）.CONCLUSION Targeted treatment should be carried out according to the characteristics of pathogenic bacteria of postherpetic neuralgia secondary infections,and effective and effective preventive measures should be taken against their risk factors,so as to reduce the incidence.

关 键 词：带状疱疹后遗神经痛 继发感染 病原菌 影响因素 

分 类 号：R378[医药卫生—病原生物学]