摘要
目的调查分析呼吸道感染患者的病原菌分布,探讨呼吸道感染的危险因素,为临床有效预防和治疗呼吸道感染提供理论依据。方法选取贵州医科大学第二附属医院2019年1月—2022年12月期间收治的42060例呼吸道感染患者,对其痰液或肺泡灌洗液病原菌进行检测。收集284例患者临床相关资料,采用单因素比较法和多因素logistic回归法对呼吸道感染患者感染的危险因素进行分析。结果2019年—2022年间临床科室共送检25033份样本,检出阳性标本4959份,阳性率为19.8%(4959/25033),其中多重耐药菌感染占18.0%(894/4959)。共检出6001株病原菌,其中革兰阳性菌20.7%(1243/6001),以金黄色葡萄球菌为主,占11.3%(680/6001);革兰阴性菌79.2%(4754/6001),以流感嗜血杆菌和肺炎克雷伯菌为主,分别占18.7%(1122/6001)和14.7%(880/6001);真菌占0.1%(白色念珠菌为主,4/6001)。单因素分析结果显示,低蛋白血症(χ^(2)=0.013,P=0.001)及住院时间(χ^(2)=0.256,P=0.014)均是导致呼吸道感染的相关危险因素。多因素Logistic回归分析结果显示,低蛋白血症、住院时间(15~30 d和≥30 d)是引起患者呼吸道感染的独立危险因素。结论呼吸道感染患者细菌感染率及耐药率高,以革兰阴性菌为主,低蛋白血症及住院时间是呼吸道感染的高危因素,可针对呼吸道感染危险因素采取针对性措施,降低患者呼吸道感染及医院感染的发生。
Objective To examine the risk factors for respiratory tract infections,study the distribution of infectious microorganisms in patients with respiratory tract infections,and offer a theoretical framework for the efficient prevention and management of respiratory tract infections in clinical practice.Methods 42060 patients with respiratory tract infections were selected from the Second Affiliated Hospital of Guizhou Medical University from January 2019 to December 2022,and their sputum or alveolar lavage fluid pathogenic bacteria were detected.The clinical data of 284 patients were collected,and the risk factors of respiratory tract infection were analyzed by single factor Comparative law and multi factor logistic Law of Return.Results From 2019 to 2022,clinical departments sent a total of 25033 samples for testing,and 4959 positive samples were detected,with a positivity rate of 19.8%(4959/25033),among which multidrug-resistant bacterial infections accounted for 18.0%(894/4959).Twenty-seven percent(1243/6001)of the 6001 pathogens identified were Gram positive bacteria,primarily Staphylococcus aureus,accounting for 11.3%(680/6001);Haemophilus influenzae and Klebsiella pneumoniae accounted for 79.2%(4754/6001)of the Gram negative bacteria,accounting for 18.7%(1122/6001)and 14.7%(880/6001)of the total,respectively;Fungi accounted for 0.1%(4/6001),and Candida albicans accounted for 0.1%(4/6001).Single factor analysis showed that hypoproteinemia(χ^(2)=0.013,P=0.001)and length of stay(x 2=0.256,P=0.014)are all related risk factors for respiratory tract infections.Multivariate logistic regression analysis showed that hypoproteinemia,length of hospital stay 15~30 days,and length of hospital stay≥30 days were independent risk factors for respiratory tract infection.Conclusion Patients with respiratory tract infections have a high bacterial infection rate and drug resistance rate,mainly gram negative bacteria.Hypoproteinemia and length of hospital stay are high-risk factors for wound infection in burn patients.Patients can have fewer hospital infections and respiratory tract infections by using targeted interventions.
作者
石磊
吴永英
聂兴旺
唐余庆
陈超
王丹琳
陶如玉
Shi Lei;Wu Yong-ying;Nie Xing-wang;Tang Yu-qing;Chen Chao;Wang Dan-lin;Tao Ru-yu(The Second Affiliated Hospital of Guizhou Medical University,Kaili Guizhou 556000)
基金
国家科技基础资源调查专项(2019FY101200)
黔东南州基础研究计划项目[黔东南科合基础(2023)15号]
黔东南州科技计划(自筹资金)项目[黔东南科合J字(2023)72号]。
关键词
呼吸道感染
病原菌分布
多重耐药菌
危险因素
细菌感染率
耐药率
respiratory tract infection
distribution of pathogenic bacteria
multi drug resistant bacteria
risk factors
bacterial infection rate
bacterial resistance rate
