2020-2022年某三甲医院发热门诊患者病例特征及病原菌特征分析  

Analysis of the characteristics of fever outpatient cases and pathogen characteristics of fever outpatient patients in a third⁃class hospital from 2020 to 2022

作　　者：韩露 王向青 李晓英 韩辛 马雯靖 HAN Lu;WANG Xiangqing;LI Xiaoying;HAN Xin;MA Wenjing(Department of Orthopedics,Tangdu Hospital,the Air Force Medical University,Xi'an,Shaanxi,China,710032;Infection DepartmentⅡof Xi'an Eighth Hospital,Xi'an,Shaanxi,China,710061)

机构地区：[1]空军军医大学唐都医院骨科,陕西西安710032 [2]西安市第八医院感染二科,陕西西安710061

出　　处：《分子诊断与治疗杂志》2024年第11期2165-2168,共4页Journal of Molecular Diagnostics and Therapy

基　　金：西安市科技计划项目(2017118SF/YX12)。

摘　　要：目的通过分析2020-2022年发热门诊患者病例特征及病原菌分布情况,为疾病的防治提供科学依据。方法收集来自空军军医大学唐都医院发热门诊在2020年1月1日至2022年12月31日就诊的患者病历数据及实验室检查、病原学检查等临床资料,并对其病例特征和病原菌特征进行分析。结果2020年-2022年期间,共纳入发热门诊的就诊患者38901例,男性占55.03%,女性占44.97%;年龄范围14~96岁。27563例(71.09%)发热门诊患者就诊时存在发热症状,大多数为低热患者(55.23%)。此外,最常见的4种症状依次为乏力(38.05%)、咽痛(33.24%)、咳嗽(29.49%)和头痛(24.49%)。发热到就诊的中位值时间为2(1,4)天,43.25%的患者在1 d内来院就诊。诊断疾病以急性上呼吸道感染最多(36.39%)。另外,9172例发热门诊患者采集病原体样本进行病原学鉴定,其中954例发热门诊患者检出病原菌,病原菌检出率10.40%(954/9172例)。共检出1328株病原菌,主要为细菌(93.75%),少量为真菌(6.25%)。其中革兰阴性菌(62.35%)主要以铜绿假单胞菌(19.13%)、肺炎克雷伯菌(14.31%)和大肠埃希菌(11.37%)为主。革兰阳性菌(31.40%)主要为金黄色葡萄球菌(12.80%)和肺炎链球菌(7.15%)。真菌以白假丝酵母菌(4.29%)为主。结论发热门诊病例仍以常见病、多发病为主,病情复杂多变,临床医务人员应掌握发热门诊病历的病例特征及病原菌特点,从而更有利于为患者提供及时有效的救治和疾病防控。Objective To analyze the characteristics of fever outpatient cases and the distribution of pathogens from 2020 to 2022,to provide a scientific basis for disease prevention and treatment.Method Medical records,laboratory tests,pathogen tests,and other clinical data from the fever clinic of the Second Affiliated Hospital of the Air Force Medical University in Baqiao District were collected between January 1,2020,and December 31,2022.The characteristics of the cases and pathogens were analyzed.Results From 2020 to 2022,a total of 38,901 patients were seen in fever clinics,consisting of 55.03%males and 44.97%females,with ages ranging from 14 to 96 years old.Among the fever outpatient cases,27,563 patients(71.09%)presented with fever symptoms,most commonly experiencing low⁃grade fevers(55.23%).The top four symptoms reported were fatigue(38.05%),sore throat(33.24%),cough(29.49%),and headache(24.49%).The median time from onset of fever to seeking medical treatment was 2(1,4)days,and 43.25%of patients sought treatment within the first day.Acute upper respiratory tract infections were the most frequently diagnosed conditions(36.39%).Of the patients,9,172 patients had pathogen samples collected for identification,with 954 fever outpatient patients testing positive for pathogens,resulting in a detection rate of 10.40%(954/9172 cases).A total of 1,328 pathogenic bacteria were identified,predominantly bacteria(93.75%)with a small proportion of fungi(6.25%).The most common Gram⁃negative bacteria were Pseudomonas aeruginosa(19.13%),Klebsiella pneumoniae(14.31%),and Escherichia coli(11.37%).Among the Gram⁃positive bacteria,Staphylococcus aureus(12.80%)and Streptococcus pneumoniae(7.15%)were the most prevalent.The main fungi identified were Candida albicans(4.29%).Conclusion Fever outpatient cases remain common and frequently encountered,often presenting with complex and variable conditions.Clinical medical personnel must have a thorough understanding of the characteristics of fever outpatient medi⁃cal records and pathoge

关 键 词：发热门诊 病例特征 感染性疾病 病原菌 

分 类 号：R446.5[医药卫生—诊断学]