哮喘患者医院感染病原菌特点及影响因素分析

Characteristics and risk factors of nosocomial infections in patients with asthma

  • 摘要: 目的 探讨哮喘患者医院感染病原菌特点及影响因素。方法 选择于2013年1月-2017年1月期间医院收治的哮喘患者845例为研究对象,采集患者痰液、尿液、血液标本,分离培养细菌,采用生物鉴定系统进行细菌鉴定。分析哮喘患者医院感染情况,病原菌分布特点和耐药性,分析哮喘患者医院感染相关影响因素。结果 845例哮喘患者中发生医院感染100例,医院感染发生率为11.83%,感染部位以下呼吸道感染58例占58.00%为主;100例医院感染患者中共分离出120株病原菌,其中革兰阴性菌78株占65.00%、革兰阳性菌36株占30.00%、真菌6株占5.00%;主要革兰阴性菌对氨曲南耐药率较高,均>80%;主要革兰阳性菌对青霉素、红霉素耐药率较高,均>85%;Logistic多元回归分析结果显示,住院时间、气管切开及机械通气为哮喘患者医院感染的影响因素。结论 哮喘患者医院感染病原菌以革兰阴性菌为主,应注意医院感染的相关影响因素,进一步采取有效的预防措施,降低医院感染的发生率。

     

    Abstract: OBJECTIVE To investigate the characteristics and risk factors of nosocomial infections in patients with asthma. METHODS A total of 845 cases of patients with asthma in our hospital from Jan. 2013 to Jan. 2017 were selected. Their sputum, urine and blood samples were collected for bacterial isolation and culture, and the bacteria were identified by biological identification system. The situation of nosocomial infections, pathogenic bacteria distribution and drug resistance in patients with asthma were analyzed, and the related factors of nosocomial infections in patients with asthma were also analyzed. RESULTS There were 100 cases of nosocomial infections occurred among 845 cases of patients with asthma, accounting for 11.83%. There were 58 cases of lower respiratory tract infections, accounting for 58.00%. A total of 120 strains of pathogenic bacteria were isolated from 100 cases of patients with nosocomial infections. Among them, 78 strains were gram-negative bacteria accounting for 65%, 36 strains were gram-positive bacteria accounting for 30.00%, and 6 strains were fungi accounting for 5%. The main gram-negative bacteria had high resistant rates to asconan, which were over 80%, and main gram-positive bacteria had high resistant rates to penicillin and erythromycin, which were over 85%. The results of logistic multivariate regression analysis showed that hospitalization time, tracheotomy and mechanical ventilation were risk factors of nosocomial infections in patients with asthma. CONCLUSION Gram-negative bacteria are the main pathogens of nosocomial infections in patients with asthma. We should pay attention to the related factors of nosocomial infections, and effective preventive measures should be further taken to reduce the incidence of nosocomial infections.

     

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