摘要
目的探讨肾病综合征患儿医院感染的易感因素,并通过对肾病综合征患儿医院感染的病原菌及其耐药性的研究以提高临床诊治水平。方法选取2008年1月-2012年1月入院治疗的肾病综合征患儿178例为研究对象,应用单因素及logistic分析医院感染相关因素;对其中发生医院感染的患儿留取痰液、血液、尿液及其他分泌物标本,并严格按照《全国临床检验操作规程》进行病原菌培养、分离、鉴定,将所有病原菌进行药敏试验,检测其耐药性。结果 178例患儿中医院感染35例,感染率为19.66%;共检出病原菌7种、205株,常见的病原菌有大肠埃希菌、肺炎克雷伯菌、流感嗜血菌,对革兰阳性菌耐药率<30.00%的药物有万古霉素、庆大霉素与环丙沙星;对革兰阴性菌耐药率<30.00%的药物有亚胺培南、美罗培南、头孢他啶及阿米卡星;通过分析认为年龄、住院时间、病程、感染前应用抗菌药物情况与诱发肾病综合征患儿医院感染的关系密切。结论肾病综合征患儿医院感染主要以大肠埃希菌、肺炎克雷伯菌为主,并且肾病综合征患儿的年龄、住院时间、病程、感染前应用抗菌药物等为诱发医院感染的相关因素。
OBJECTIVE To explore the predisposing factors for nosocomial infections in the children with nephrotic syndrome and analyze the distribution and drug resistance of pathogens causing nosocomial infections so as to improve level of clinical diagnosis and treatment. METHODS A total of 178 children with nephrotic syndrome. who were treated in the hospital from Jan 2008 to Jan 2012. were enrolled in the study. then the univariate analysis and the logistic analysis were performed for the related factors for nosocomial infections. The sputum specimens. blood specimens. urine specimens. and other secretions specimens were sampled from the children with nosocomial infections. The culture. isolation. and identification of the pathogens were carried out by strictly referring to the National Clinical Laboratory Procedures. and the drug susceptibility testing was performed. RESULTS Among the 178 children. the nosocomial infections occurred in 35 cases with the infection rate of 19. 66%; totally 205 strains （ 7 species） of pathogens were isolated. among which the Escherichia coli, Klebsiella pneumoniae , and Haemophilus inJluenzae were the most common species. The drug resistance rates of the gram-positive bacteria to vancomycin. gentamicin. and ciprofloxacin were less than 30. 00 %; the drug resistance rates of the gramnegative bacteria to imipenern , meropenern , ceftazidime , and amikacin were less than 30. 00 %. The result of analysis suggested that the incidence of nosocomial infections in the children with nephrotic syndrome was closely related to the age. length of hospital stay, illness course, and use of antibiotics before infections. CONCLUSION E. coli and K. pneumoniae are the predominant species of pathogens causing nosocomial infections in the children with nephrotic syndrome; the age. length of hospital stay. illness course. and use of antibiotics before infections are the predisposing factors for the nosocomial infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第5期1265-1267,共3页
Chinese Journal of Nosocomiology
基金
聊城市卫生局计划基金项目(SL-2009C046)
关键词
肾病综合征
患儿
医院感染
病原菌
影响因素
Nephrotic syndrome
Children
Nosocomial infection
Pathogen
Risk factor
