糖尿病患者医院感染病原菌分布与影响因素分析  

Analysis of pathogen distribution and influencing factors of nosocomial infections in diabetic patients

作　　者：郭静[1] 杨燕[2] 金晓希[2] 王沛[2] 祝官梅[1] GUO Jing;YANG Yan;JIN Xiao-xi;WANG Pei;ZHU Guan-mei(First People's Hospital of Jingmen,Jingmen,Hubei 448000,China)

机构地区：[1]荆门市第一人民医院内分泌科,湖北荆门448000 [2]荆门市第一人民医院检验科,湖北荆门448000

出　　处：《中华医院感染学杂志》2019年第15期2304-2307,2317,共5页Chinese Journal of Nosocomiology

基　　金：湖北省卫生计生委面上基金资助项目(WJ2017M235)

摘　　要：目的探讨糖尿病患者医院感染的病原菌分布情况及影响因素。方法回顾性分析2016年1月-2018年1月荆门市第一人民医院收治的90例发生医院感染的糖尿病患者作为感染组,并选取同期住院但未发生感染的糖尿病患者90例作为对照组,分析诱发糖尿病患者医院感染的病原菌分布特点及感染部位,并对糖尿病患者医院感染的影响因素进行单因素和Logistic多因素回归分析。结果对90例医院感染患者进行病原菌培养,共培养出病原菌90株,其中革兰阴性菌51株占56.67%,革兰阳性菌34株占37.78%、真菌5株占5.56%;糖尿病患者医院感染发生部位中,泌尿系统感染发生率高于胃肠道、皮肤软组织及口腔黏膜发生率,差异有统计学意义(P<0.001);经Logistic多因素分析后结果表明,年龄、病程、糖尿病并发症、空腹血糖水平、侵入性操作、抗菌药物使用是诱发糖尿病患者医院感染的影响因素(P<0.05)。结论糖尿病患者医院感染病原菌主要以革兰阴性菌为主,病原菌的分布以呼吸系统及泌尿系统为主,主要影响因素为年龄、病程、糖尿病并发症、空腹血糖水平、侵入性操作以及抗菌药物的使用。OBJECTIVE To investigate the distribution and influencing factors of pathogens in nosocomial infections of diabetic patients.METHODS A retrospective analysis of 90 cases of hospitalized diabetic patients admitted to the First People’s Hospital of Jingmen from Jan.2016 to Feb.2018 was conducted,and these patients were taken as the infected group.Another 90 patients with diabetes who were hospitalized but not infected at the same time were selected as the control group.The distribution characteristics of pathogens and infection sites in nosocomial infections of diabetic patients were analyzed.Univariate and Logistic multivariate regression analyses were conducted to summarize the influencing factors of nosocomial infection in diabetic patients.RESULTS Pathogen culturing was conducted for the 90 cases of patients with nosocomial infection,and 90 strains of pathogens were isolated,in which 51 strains of Gram-negative bacteria accounted for 56.67%,34 strains of Gram-positive bacteria accounted for 37.78%and 5 strains of fungi accounted for 5.56%.The incidence of urinary tract infection was significantly higher than that of gastrointestinal tract,skin soft tissue and oral mucosa infections(P<0.001).Logistic multivariate analysis showed that age,duration of disease,diabetic complications,fasting blood glucose levels,invasive procedures,and antibiotic use were the main influencing factors of nosocomial infection in diabetic patients(P<0.05).CONCLUSION The pathogens of nosocomial infection in diabetic patients are mainly Gram-negative bacteria,and the distribution of pathogenic bacteria is concentrated in the respiratory system and urinary system.The main influencing factors are age,duration of disease,diabetic complications,fasting blood glucose levels,invasive procedures,and the use of antibiotics.

关 键 词：糖尿病 医院感染 病原菌 影响因素 

分 类 号：R181.3[医药卫生—流行病学]