急性细菌性皮肤和皮肤结构感染患者血液感染危险多因素分析  

Risk factors analysis of blood infection in patients with acute bacterial skin and skin structure infection

作　　者：袁玲 汪继平[1] 李强 周丽 肖敏 方琴[1] Yuan Ling;Wang Jiping;Li Qiang;Zhou Li;Xiao Min;Fang Qin(Department of Infectious Disease,the People's Hospital of Jianyang City,Sichuan Jianyang 641400,China;Department of Emergency,the People's Hospital of Jianyang City,Sichuan Jianyang 641400,China)

机构地区：[1]简阳市人民医院感染科,四川简阳641400 [2]简阳市人民医院急诊科,四川简阳641400

出　　处：《新发传染病电子杂志》2023年第2期63-67,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：四川省卫生和计划生育委员会科研课题(17PJ363)。

摘　　要：目的研究急性细菌性皮肤和皮肤结构感染(ABSSSI)患者发生血液感染(BSI)的人口统计学因素和临床特征,并分析其BSI危险因素。方法选择2017年1月至2021年1月期间就诊于简阳市人民医院的ABSSSI患者。病例组为入院后48h内发生BSI的患者,对照组为无BSI的ABSSSI患者。对两组患者进行回顾性对照研究,并通过多因素Logistic回归分析ABSSSI患者BSI的危险因素。结果研究病例共纳入392例,其中病例组196例,对照组196例。ABSSSI患者BSI的危险因素有男性(OR=1.85,95%CI=1.11~3.66)、急性肾功能衰竭(OR=2.08,95%CI=1.18~3.66)、既往住院史(aOR=2.41,95%CI=1.24~4.93)、乡村居民(aOR=2.18,95%CI=1.38~3.4)、外周血白细胞增多(aOR=2.24,95%CI=1.41~3.55)、体温异常(aOR=2.86,95%CI=1.66~4.93)。结论人口统计学因素中男性、既往住院史、乡村居民以及临床特征中急性肾功能衰竭、外周血白细胞增多、体温异常都与ABSSSI患者继发BSI高度相关,是BSI主要高危因素。本研究结果能为ABSSSI伴BSI患者的早期处理提供预警。Objective To study the demographic factors and clinical characteristics of blood infection(BSI)in patients with acute bacterial skin and skin structure infection(ABSSSI),and to analyze which factors are the risk factors of BSI.Method Patients with ABSSSI who visited the People's Hospital of Jianyang City between January 2017 and January 2021 were selected.The case group was patients who developed bloodstream infection(BSI)within 48h after admission,and the control group was ABSSSI patients without bloodstream infection(BSI).A retrospective case-control study was performed on both groups.Independent predictors of bloodstream infection(BSI)in ABSSSI patients were sought by multifactorial logistic regression analysis.Result Three hundred ninety-two patients were included in the study,including 196 cases in the case group and 196 cases in the control group.Independent predictors of BSI in ABSSSI patients were male(OR=1.85,95%CI=1.11~3.66),acute renal failure(OR=2.08,95%CI=1.18~3.66),history of the previous hospitalization(OR=2.41,95%CI=1.24~4.93),Rural residents(aOR=2.18,95%CI=1.38~3.4),leukocytosis(OR=2.24,95%CI=1.41~3.55),abnormal body temperature(aOR=2.86,95%CI=1.66~4.93).Conclusion Among demographic factors,male,previous hospitalization history,rural residents and clinical characteristics of acute renal failure,leukocytosis and abnormal body temperature are highly correlated with secondary BSI in patients with ABSSSI,which are the main high-risk factors of BSI.The results of this study can provide early warning for the early treatment of ABSSSI patients with BSI and can improve the prognosis of patients.

关 键 词：急性细菌性皮肤和皮肤结构感染 血液感染 危险因素 人口统计学 临床特征 

分 类 号：R378[医药卫生—病原生物学]