糖尿病住院患者医院感染病原菌分布及炎症因子变化情况研究  

Distribution of nosocomial infection pathogens and changes of inflammatory factors of diabetes hospitalized patients

作　　者：赵玲[1] 楼波[1] 金华 崔伟娟 孟祥君[1] 

机构地区：[1]杭州市余杭区第一人民医院内分泌科,浙江杭州311100 [2]杭州市余杭区第一人民医院检验科,浙江杭州311100

出　　处：《中华医院感染学杂志》2017年第23期5340-5343,共4页Chinese Journal of Nosocomiology

摘　　要：目的调查糖尿病住院患者的医院感染情况、对患者的病原菌构成情况进行分析,并掌握感染患者的炎症因子变化情况为临床实践提供参考依据。方法选取2015年10月-2016年9月期间医院临床收治的糖尿病住院患者844例,统计糖尿病住院患者的医院感染情况,采用单因素分析和多因素回归的分析方法统计分析导致糖尿病患者医院感染发生的危险因素,并对患者的血清样本进行病原菌检测,同时对感染患者和非感染患者的相关血清炎症因子指标水平进行比较研究。结果 844例糖尿病住院患者中有116例患者发生医院感染,感染率为13.74%;116例糖尿病住院感染患者共检出病原菌168株,其中革兰阴性菌122株占72.62%、革兰阳性菌37株占22.02%、真菌9株占5.36%;多因素分析结果显示:年龄、住院时间、病程、空腹血糖、抗菌药物使用、侵入操作是导致糖尿病住院患者感染的独立危险因素(P<0.05);感染患者的补体C3、C4,降钙素原(PCT)、C-反应蛋白(CRP)及白细胞(WBC)等指标高于非感染患者,感染患者的CD_3^+ CD_4^+和CD_3^+ CD_8^+低于非感染患者(P<0.05)。结论糖尿病住院患者的医院感染情况应引起临床重视,导致患者感染的病原菌以革兰阴性菌为主,患者感染后的相关临床因子会发生异常改变。OBJECTIVE To investigate the nosocomial infections,pathogen composition and changes of inflammatory factors of diabetes hospitalized patients,and to grasp the changes of inflammatory factors in infected patients,so as to provide references for clinical practice.METHODS A total of 844 hospitalized patients with diabetes mellitus from Oct.2015 to Sep.2016 were chosen.The nosocomial infections in hospitalized patients with diabetes mellitus was taken for statistics.The risk factors of nosocomial infections in diabetic patients were analyzed by univariate analysis and multivariate regression analysis.The patient＇s serum samples were taken for pathogens test.The levels of related serum inflammatory factors of the infected patients and non-infected patients were taken for comparative study.RESULTS Totally 116 cases of nosocomial infections occurred in the study subjects,and the infection rate was 13.74%.Totally 168 strains of pathogens were detected in 116 patients with diabetes mellitus infections.Among them,122 were gram-negative bacteria（72.62%）,37 were gram-positive bacteria（22.02%）and 9 were fungi,accounting for 72.62%,22.02%,and 5.36%,respectively.Multivariate analysis showed that,age,length of stay,course of disease,fasting blood glucose,antimicrobial use and invasive operation were independent risk factors for infections in hospitalized patients with diabetes mellitus（P〈0.05）.The levels of complement C3,C4,PCT,CRP and WBC in infected patients were higher than those in non-infected patients.The levels of CD_3~＋ CD_4~＋ and CD_3~＋ CD_8~＋in infected patients were significantly lower than those in non-infected patients（P〈0.05）.CONCLUSION Nosocomial infections in hospitalized patients with diabetes should pay attention to clinical attention,the pathogens leading to infections were mainly gram-negative bacteria.The relevant clinical factors will be with abnormal changes for patients with infections.

关 键 词：糖尿病 医院感染 病原菌 炎症因子 

分 类 号：R378[医药卫生—病原生物学]