某院ICU患者抗生素相关性腹泻病原菌分布情况及危险因素分析  

Distribution of pathogenic bacteria and risk factors analysis of antibiotic-associated diarrhea in ICU patients in a hospital

作　　者：邵兴 童洪杰 SHAO Xing;TONG Hong-jie(Jinhua Hospital Affiliated to Zhejiang University School of Medicine,Zhejiang 321000,China)

机构地区：[1]浙江大学医学院附属金华医院,浙江321000

出　　处：《中国卫生检验杂志》2023年第20期2477-2479,2488,共4页Chinese Journal of Health Laboratory Technology

基　　金：金华市中医药科学技术研究计划项目(2023KY01)。

摘　　要：目的探讨重症监护病房(ICU)患者抗生素相关性腹泻病原菌分布情况及危险因素。方法选取2019年1月—2022年1月本院收治的120例继发抗生素相关性腹泻的ICU患者作为观察组,另选取同期ICU未继发抗生素相关性腹泻患者120例作为对照组。观察抗生素相关性腹泻患者病原菌分布情况,比较2组患者临床资料。结果120例患者中共检测出178株病原菌,其中革兰阴性菌115株,占64.61%,以大肠埃希菌为主;革兰阳性菌52株,占29.21%,以难辨梭状芽胞杆菌为主;真菌11株,占6.18%,以白色念珠菌为主。经多因素logistic回归分析证实,年龄≥60岁、禁食、抗生素使用时间≥7 d、联合使用抗生素是ICU患者继发抗生素相关性腹泻的危险因素(P<0.05)。结论大肠埃希菌、肺炎克雷伯菌和难辨梭状芽胞杆菌在ICU抗生素相关性腹泻患者中占比较高。对于高龄、病情危重患者,应严格掌握抗生素使用指征,减少或避免联合或长期抗生素治疗。Objective This paper aims to explore the distribution of pathogenic bacteria and risk factors of antibiotic-associated diarrhea in ICU patients.Methods A total of 120 ICU patients with antibiotic-associated diarrhea admitted to our hospital from January 2019 to January 2022 were selected as the observation group,and 120 ICU patients without antibiotic-associated diarrhea during the same period were selected as the control group to observe the distribution of pathogenic bacteria in patients with antibiotic-associated diarrhea and compare the clinical data of the two groups.Results A total of 178 strains of pathogenic bacteria were detected in 120 patients,including 115 strains of Gram-negative bacteria,accounting for 64.61%,mainly Escherichia coli,52 strains of Gram-positive bacteria,accounting for 29.21%,mainly Clostridium difficile,and 11 strains of Fungi,accounting for 6.18%,mainly Candida albicans.Multivariate logistic regression analysis confirmed that age≥60 years,fasting,antibiotic use time≥7 d and combined use of antibiotics were risk factors for secondary antibiotic-associated diarrhea in ICU patients.Conclusion Escherichia coli,Klebsiella pneumoniae and Clostridium difficile account for a relatively high proportion in ICU patients with antibiotic-associated diarrhea.For the elderly and critically ill patients,it is needed to strictly control the indications of antibiotic use and reduce or avoid a combined or long-term antibiotic treatment.

关 键 词：重症监护病房 抗生素相关性腹泻 病原菌 危险因素 

分 类 号：R446[医药卫生—诊断学]