泌尿外科危重症患者病原菌感染种类分布及危险因素分析  

Analysis of the distribution of pathogenic bacterial infection types and risk factors in critically ill urologic patients

作　　者：许开玲 姜福金[1] 王高峰 薛颖 乔艳 张雪华[1] XU Kailing;JIANG Fujin;WANG Gaofeng;XUE Ying;QIAO Yan;ZHANG Xuehua(Department of Urology,Huai′an Second People′s Hospital,Huai′an,Jiangsu 223001,China)

机构地区：[1]淮安市第二人民医院泌尿外科,江苏淮安223001

出　　处：《医学动物防制》2023年第12期1177-1181,共5页Journal of Medical Pest Control

基　　金：江苏省卫生计生委医学科研课题(2021MSXM02)。

摘　　要：目的探究某院2016年1月—2021年1月泌尿外科危重症住院患者病原菌感染部位和类型的分布特征及其危险因素。方法从某院2016年1月—2021年1月收治的泌尿外科转入重症监护室(intensive care unit,ICU)的患者中选取1000例临床资料进行回顾性分析。收集患者病原菌菌株培养与药敏试验信息及其相关临床资料,分析患者感染部位与病原菌感染分布构成比。参照《医院感染诊断标准》将患者按照是否发生医院感染分为感染组和未感染组,采用多因素logistic分析患者病原菌感染的危险因素。结果ICU泌尿外科住院患者泌尿道病原菌感染检出率为54.17%;大肠埃希菌检出率最高,为36.67%;ICU泌尿外科住院患者病原菌感染的危险因素包括年龄≥60岁、糖尿病、格拉斯哥昏迷量表(glasgow coma scale,GCS)评分≤8分、留置导尿管、操作失误、导尿管留置时间≥7d。结论大肠埃希菌是ICU泌尿外科住院患者发生病原菌感染的主要病原菌,应对留置导尿管和操作失误等病原菌感染可控危险因素进行重点防控。Objective To investigate the distribution characteristics and risk factors of the sites and types of pathogenic bacterial infections in critically ill urological inpatients during January 2016 to January 2021 in a hospital.Methods The clinical data of 1000 cases selected from the urology patients transferred to intensive care unit(ICU)admitted to a hospital from January 2016 to January 2021 were retrospectively analyzed.The information of culture and drug sensitivity test of pathogenic bacteria strains of patients and their related clinical data were collected to analyze the patients′infection sites and the composition ratio of pathogenic bacteria infection distribution.Referring to the Diagnostic Criteria for Hospital Infections,the patients were divided into the infected and uninfected groups according to whether or not they had hospital infections,and the risk factors for pathogenic bacterial infections were analyzed by multifactorial logistic.Results The detection rate of urinary tract pathogenic bacterial infections in ICU urology inpatients was 54.17%.Escherichia coli was detected at the highest rate of 36.67%.The risk factors for pathogenic bacterial infections in ICU urology inpatients included age over 60 years,diabetes mellitus,scores of less than 8 on the glasgow coma scale(GCS),indwelling urinary catheter,operator errors,catheter retention time over 7 days.Conclusion Escherichia coli is the main pathogen for pathogenic bacterial infections in ICU urology inpatients,and focus should be placed on the prevention and control of controllable risk factors for pathogenic bacterial infections,such as catheters retention and operational errors.

关 键 词：重症监护室 病原菌感染 危险因素 导尿管留置时间 泌尿系统疾病 大肠埃希菌 

分 类 号：R446.5[医药卫生—诊断学]