纹带棒状杆菌呼吸道感染临床危险因素  

Analysis of clinical risk factors for Corynebacterium striatum respiratory tract infection

作　　者：薛佳琦 周海健[2] 李娟[2] 周君辰 段立科 施淇源 刘泽梁 高鹏芳 韩肖 董爱英 XUE Jia-qi;ZHOU Hai-jian;LI Juan;ZHOU Jun-chen;DUAN Li-ke;SHI Qi-yuan;LIU Ze-liang;GAO Peng-fang;HAN Xiao;DONG Ai-ying(University of Science and Technology Affiliated Hospital,Tangshan,Hebei 063000,China;不详)

机构地区：[1]华北理工大学附属医院检验科,河北唐山063000 [2]中国疾病预防控制中心传染病预防控制所,传染病预防控制国家重点实验室,北京102206

出　　处：《中华医院感染学杂志》2022年第24期3726-3730,共5页Chinese Journal of Nosocomiology

基　　金：中国煤炭工业协会2018年度科学技术研究指导性计划项目(MTKJ2018-267)。

摘　　要：目的探讨影响纹带棒状杆菌呼吸道感染的临床危险因素,建立预防控制感染意识,减少纹带棒状杆菌呼吸道感染的发生。方法回顾性分析2017年10月-2018年1月华北理工大学附属医院检出纹带棒状杆菌的213例患者资料,分析该菌的临床科室分布特点并对其易患因素进行统计分析。结果患者集中在重症医学病房和神经外科病房,根据分组标准分为纹带棒状杆菌致病组和定植组。致病组的病死率高于定植组(P<0.05)。单因素分析中年龄、血液系统疾病、消化系统疾病、呼吸系统疾病、神经系统疾病、外伤、恶性肿瘤、低蛋白血症、感染前使用激素、感染前使用抗真菌药物、侵入性操作中留置侵入性器械、留置中心静脉导管时间、胸穿、腰穿、气管切开、呼吸机辅助机械通气、手术、感染前入住ICU是纹带棒状杆菌呼吸道感染的危险因素;多因素分析中感染前使用激素(OR=0.197,P=0.002)、低蛋白血症(OR=0.287,P=0.032)、感染前入住ICU(OR=13.594,P<0.001)是纹带棒状杆菌呼吸道感染的危险因素。结论长时间使用激素且有侵入性操作的免疫力低下的患者容易引起纹带棒状杆菌在呼吸道的感染,临床工作人员需提高对此类患者的关注意识,及早预防,减少患者发生纹带棒状杆菌的感染和死亡。OBJECTIVE To explore the clinical risk factors for respiratory tract infection of Corynebacterium striatum,and to establish the awareness of infection prevention and control,reducing the occurrence of respiratory tract infection of C.striatum.METHODS The data of 213 patients infected with C.striatum in the Affiliated Hospital of North China University of Science and Technology from Oct 2017 to Jan 2018 were retrospectively analyzed,and the distribution characteristics of clinical departments and the risk factors for the bacteria were statistically analyzed.RESULTS The infected patients were mainly from the ICU and neurosurgical wards,which were divided the pathogenic group and colonization group.The mortality in the pathogenic group was higher than that in the colonization group(P<0.05).Univariate analysis showed that age,diseases of blood system,digestive system,respiratory system and nervous system,trauma,infection of malignant tumor,hypoalbuminemia use of hormone,infection before the use of antifungal drugs,invasive operation in lien invasive devices,central venous catheter indwelling time,chest wear,waist,tracheotomy,breathing machine auxiliary mechanical ventilation,surgery and infection before ICU admission were risk factors for respiratory morbidity of C.striatum.Multivariate analysis showed that pre-infection hormone use(OR=0.197,P=0.002),hypoproteinemia(OR=0.287,P=0.032),lumbar puncture(OR=0.035,P=0.004)and tracheotomy(OR=13.594,P<0.001)were risk factors for respiratory tract infection caused by C.striatae.CONCLUSION Patients with low immunity who use hormones for a long time and have invasive operations are prone to cause C.striatum infection in the respiratory tract.Early prevention can reduce the incidence of C.striatum infection and death.

关 键 词：纹带棒状杆菌 呼吸道感染 临床表现 危险因素 

分 类 号：R56[医药卫生—呼吸系统]