肺炎支原体肺炎住院患儿合并细菌感染的病原学分布及高危因素研究  

Etiological Distribution and High-Risk Factors of Concurrent Bacterial Infection in Hospitalized Children with Mycoplasma Pneumoniae Pneumonia

作　　者：寿涛 周碧 杨林风 朱峰[1] 刘祥蕾 SHOU Tao;ZHOU Bi;YANG Linfeng(Suzhou Hospital,Anhui Medical University,Anhui Suzhou 234000,China)

机构地区：[1]安徽医科大学附属宿州医院儿童重症医学科,安徽宿州234000

出　　处：《河北医学》2024年第11期1887-1892,共6页Hebei Medicine

基　　金：2023年安徽省临床医学研究转化专项项目,(编号:202304295107020119);2023年度宿州市自筹资金项目,(编号:SZZCZJ202328)。

摘　　要：目的:探究肺炎支原体肺炎(MPP)住院患儿合并细菌感染的病原学分布及其高危因素。方法:选取2022年6月至2024年4月期间本院收治的520例住院MPP患儿作为研究对象,所有研究对象均行痰培养病原检测,依据全自动微生物鉴定结果记录合并细菌感染发生情况及MPP住院患儿合并细菌感染病原学分布结果,将合并细菌感染患儿设为感染组,其余患儿设为非感染组,单因素分析MPP住院患儿合并细菌感染的影响因素,多因素Logistic回归分析MPP住院患儿合并细菌感染的高危因素。结果:520例住院MPP患儿痰培养结果显示,细菌感染阳性177例,阴性343例,细菌感染发生率为34.04%;177例细菌感染阳性MPP患儿共检出病原菌182株,革兰氏阴性菌与阳性菌分别检出121株、61株,分别占比66.48%、33.52%。检出革兰氏阴性菌以肺炎克雷伯菌(33.52%)、铜绿假单胞菌(21.43%)为主,检出革兰氏阴性菌以金黄色葡萄球菌(25.82%)为主;感染组年龄≤3岁、体温发热>1周、皮疹、C反应蛋白>100mg/L、呼吸支持、住院时间>14d所占比率均高于非感染组,抗生素使用时间长于非感染组,比较差异均有统计学意义;多因素Logistic回归分析结果显示,年龄≤3岁(OR=3.086,95%CI:1.497~6.361)、抗生素使用时间(OR=1.104,95%CI:1.031~1.182)、营养不良(OR=3.043,95%CI:1.697~5.458)、体温发热>1周(OR=3.068,95%CI:1.639~5.774)、皮疹(OR=2.735,95%CI:1.540~4.856)、C反应蛋白>100mg/L(OR=3.105,95%CI:1.539~6.263)、呼吸支持(OR=2.954,95%CI:1.726~5.053)、住院时间>14d(OR=2.989,95%CI:1.703~5.246)为导致MPP住院患儿合并细菌感染的高危因素(P<0.05)。结论:MPP住院患儿合并细菌感染病原类型以革兰阴性菌为主,其中肺炎克雷伯菌、铜绿假单胞菌等病原居感染前列,MPP住院患儿合并细菌感染高危因素多样,可依据这些因素针对性采取措施预防细菌感染。Objective:To explore the etiological distribution and high-risk factors of concurrent bacterial infection in hospitalized children with Mycoplasma pneumoniae pneumonia(MPP).Methods:A total of 520 hospitalized children with MPP in the hospital were selected from June 2022 to April 2024 as the research subjects,and they underwent sputum culture pathogen detection.According to the results of automatic microbial identification,the occurrence of concurrent bacterial infection and etiological distribution results of concurrent bacterial infection in these research subjects were recorded.The children with concurrent bacterial infection were set as the infection group,and the other children were set as the non-infection group.Univariate analysis was used to analyze the influencing factors of concurrent bacterial infection in hospitalized children with MPP.Multivariate Logistic regression analysis was adopted to analyze the high-risk factors of concurrent bacterial infection in hospitalized children with MPP.Results:Sputum culture of 520 hospitalized children with MPP showed that 177 cases were positive for bacterial infection and 343 cases were negative,and the incidence of bacterial infection in hospital was 34.04%.182 strains of pathogenic bacteria were detected in 177 hospitalized MPP children with positive bacterial infection,including 121 strains of Gram-negative bacteria(66.48%)and 61 strains of Gram-positive bacteria(33.52%).Gram-negative bacteria were mainly Klebsiella pneumoniae(33.52%)and Pseudomonas aeruginosa(21.43%),and Gram-negative bacteria were mainly Staphylococcus aureus(25.82%).The proportions of age≤3 years old,malnutrition and fever>1 week,skin rash,C-reactive protein>100 mg/L,respiratory support and hospitalization time>14 days in the infection group were higher compared with those in the non-infection group,and the duration of antibiotic use was longer(P<0.05).Multivariate Logistic regression analysis indicated that age≤3 years old(OR=3.086,95%CI:1.497-6.361),duration of antibiotic use(OR=1.104

关 键 词：肺炎支原体肺炎 细菌感染 病原学分布 高危因素 

分 类 号：R725.6[医药卫生—儿科] R446.5[医药卫生—临床医学]