革兰阴性杆菌血流感染病原菌特征及易感因素分析

发布时间：2018-12-27 19:04

【摘要】：目的:分析革兰阴性(G-)杆菌血流感染的病原菌特征和易感因素。方法:回顾性分析广东省人民医院2012年10月至2014年12月全部重症加强监护病房(ICU)内G-杆菌血流感染患者,比较血培养G-杆菌阳性与阴性患者的相关参数,用Logistic回归分析其易感因素。结果:两年间ICU内发生血培养为G-杆菌148株,主要包括鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌肺炎亚种。单因素分析显示,G-杆菌血流感染时患者年龄大,患冠心病或充血性心力衰竭、脑血管病、慢性肾功能不全、高血压比例明显增加,血培养前住院时间、使用血管活性药物比率及入院前静脉抗生素使用率明显增加,血浆白蛋白水平明显降低(P0.05)。冠心病或心力衰竭、慢性肾功能不全、抗生素暴露为ICU内G-杆菌血流感染的独立易感因素。结论:冠心病或充血性心力衰竭、慢性肾功能不全及抗生素暴露是ICU患者发生G-杆菌血流感染的易感因素。
[Abstract]:Objective: to analyze the pathogenic characteristics and susceptible factors of Gram-negative bacilli (G-) blood stream infection. Methods: from October 2012 to December 2014 in Guangdong Provincial people's Hospital, all patients with G- bacillus blood flow infection in (ICU) of intensive care unit were analyzed retrospectively, and the parameters of positive and negative patients with G- bacillus in blood culture were compared. The susceptible factors were analyzed by Logistic regression analysis. Results: during the past two years, 148 strains of G- bacillus were cultured in ICU, including Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae pneumonia subspecies. Univariate analysis showed that the patients with G- bacillus blood stream infection were older, had coronary heart disease or congestive heart failure, cerebrovascular disease, chronic renal insufficiency, increased the proportion of hypertension, and spent time in hospital before blood culture. The ratio of vasoactive drugs and the use rate of intravenous antibiotics before admission were significantly increased and the plasma albumin level was significantly decreased (P0.05). Coronary heart disease or heart failure, chronic renal insufficiency and antibiotic exposure were independent risk factors for G- bacillus blood flow infection in ICU. Conclusion: coronary heart disease or congestive heart failure, chronic renal insufficiency and antibiotic exposure are the risk factors for G- bacillus blood flow infection in patients with ICU.
【作者单位】：广东省人民医院(广东省医学科学院)急危重症医学部;
【基金】：国家自然科学基金项目(编号:81271329,81471237)
【分类号】：R446.5

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