摘要
目的探究分析弓形虫抗体阳性自然妊娠先兆流产患者医院感染的病原学特点及危险因素。方法选择医院2014年3月至2017年3月收治的231例弓形虫抗体阳性自然妊娠先兆流产患者作为研究对象,根据患者是否发生感染分为感染组和未感染组,分析入组患者发生医院感染的病原学特点及危险因素。结果231例弓形虫抗体阳性自然妊娠先兆流产患者中,发生医院感染共51例。经宫颈分泌物培养或血培养共发现病原菌69株,其中以真菌为主,占42.03%,革兰阳性菌占33.33%,革兰阴性菌占24.64%。白色念球菌对克霉唑、两性霉素B、咪康唑的药物敏感性较好。链球菌对左氧氟沙星、万古霉素具有较好的药物敏感性,对阿莫西林、四环素、红霉素具有较高的耐药性。多因素Logistic分析显示,孕妇与动物密切接触、喜食生肉、孕妇文化程度在高中及以下、先兆流产出血量≥50 mL、住院时间≥5 d均是影响弓形虫抗体阳性自然妊娠先兆流产患者发生医院感染的独立危险因素(P<0.05)。结论弓形虫抗体阳性自然妊娠先兆流产患者发生医院感染受多方面因素影响,临床上需要针对感染常见的病原菌进行抗菌药物预防及治疗。针对每位患者可能合并的危险因素,给予合理的预防对策,降低患者医院感染发生率。
Objective To study etiological characteristics and risk factors of nosocomial infection in natural pregnancy patients with threatened abortion and positive antibodies to Toxoplasma gondii.Methods 231 patients with Toxoplasma gondii antibody-positive natural pregnancy threatened abortion admitted to the hospital from March2014 to March 2017 were selected as subjects.According to whether the patient was infected,the infection group was divided into the infected group and the uninfected group.The pathogenic characteristics and risk factors of hospital infection occurred in the patients.Results Among the 231 patients enrolled in the study,nosocomial infection occurred in 51 patients.A total of 69 strains of pathogenic bacteria were identified from cervix secretion or blood culture.Among them,42.03%were fungi,33.33%were Gram-positive bacteria and 24.64%were Gramnegative bacteria.Candida albicans is sensitive to clotrimazole,amphotericin B and miconazole.Streptococcus has good drug sensitivity to levofloxacin and vancomycin,and has high resistance to amoxicillin,tetracycline and erythromycin.Multivariate logistic analysis showed that the close contact between pregnant women and animals,willing to eat raw meat,pregnant women’s education degree in high school or below,the volume of bleeding that threatened abortion more than 50 mL,hospitalization stay more than 5 days were independent risk factors for nosocomial infection in natural pregnancy patients whose positive antibodies to Toxoplasma gondii with threatened abortion(P<0.05).Conclusions The incidence of nosocomial infection in natural pregnancy patients whose positive antibodies to Toxoplasma gondii with threatened abortion is affected by many factors.It is necessary to prevent and treat the common pathogenic bacteria.In view of the possible risk factors for each patient,reasonable preventive measures should be given to reduce the incidence of nosocomial infection.
作者
叶蔚
颜露春
楚佳奇
张颖
黄思毅
王明蕊
曹春燕
YE Wei;YAN Luchun;CHU Jiaqi;ZHANG Ying;HUANG Siyi;WANG Mingrui;CAO Chunyan(Department of Obstetrics,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第23期3608-3612,共5页
The Journal of Practical Medicine
基金
国家自然科学基金项目（编号：81771612）
