影响感染科患者发生抗生素相关性腹泻的危险因素分析  

Risk factors of antibiotic-associated diarrhea in patients in Department of Infectious Disease

作　　者：胡彩虹 饶先林[1] 吴红娣[1] 陆增生[1] HU Caihong;RAO Xianlin;WU Hongdi;LU Zengsheng(Department of Infectious Disease,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China)

机构地区：[1]浙江省立同德医院感染科,浙江杭州310012

出　　处：《中国现代医生》2022年第13期157-160,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2021ZB061)。

摘　　要：目的探讨感染科患者发生抗生素相关性腹泻(AAD)的发病机制及其危险因素,为临床早期预防提供依据。方法选取2018年6月至2020年10月浙江省立同德医院感染科收治的283例患者进行随访调查,依据其住院期间是否发生AAD将其分为AAD组(77例)和非AAD组(206例);分析感染科患者住院期间的AAD发生率,比较两组患者间的各因素分布差异性,并采用逐步logistic回归法筛选影响感染科患者发生AAD的相关危险因素。结果283例感染科患者住院期间AAD发生率为27.21%(77/283);影响感染科患者住院期间发生AAD的危险因素包括年龄(OR=3.117)、营养风险(OR=4.035)、病情危重(OR=4.586)、联用抗生素(OR=4.175)、抗生素使用时间(OR=2.807)、住院时间(OR=2.246),而使用微生态制剂(OR=0.483)则为保护性因素。结论感染科患者住院期间的AAD发生率高达27.21%,应摸清AAD的发病机制及其相关高危因素,早期采取预防措施,降低感染科的AAD发生率,改善患者的预后。Objective To explore the pathogenesis and risk factors of antibiotic-associated diarrhea(AAD)in patients with infectious diseases,and to provide evidence for early clinical prevention.Methods A follow-up survey was conducted on 283 patients admitted to the Department of Infectious Disease of Tongde Hospital of Zhejiang Province from June 2018 to October 2020.They were divided into the AAD group(77 patients)and the non-AAD group(206 patients)according to whether AAD occurred during hospitalization.The incidence of AAD during hospitalization was analyzed.The differences in the distribution of various factors were compared between the two groups.The stepwise logistic regression method was used to screen the relevant risk factors of AAD in infectious diseases.Results The incidence of AAD during hospitalization of 283 patients in the Department of Infectious Disease was 27.21%(77/283).The risk factors of AAD during hospitalization in patients in the Department of Infectious Disease included age(OR=3.117),nutritional risk(OR=4.035),critical illness(OR=4.586),combination use of antibiotics(OR=4.175),length of antibiotic use(OR=2.807),and hospitalization length(OR=2.246).The use of probiotics(OR=0.483)was a protective factor.Conclusion The incidence of AAD during hospitalization in the Department of Infectious Disease is as high as 27.21%.The pathogenesis of AAD and related high-risk factors should be investigated.Early preventive measures should be taken to reduce the incidence of AAD in the Department of Infectious Disease and improve the prognosis of patients.

关 键 词：感染科 抗生素相关性腹泻 菌群失调 危险因素 

分 类 号：R969.3[医药卫生—药理学]