慢性肾功能衰竭血液透析患者医院感染病原菌分布与临床特征分析

发布时间：2018-06-03 22:35

本文选题：慢性肾功能衰竭 + 血液透析　；参考：《中华医院感染学杂志》2015年10期

【摘要】：目的探讨慢性肾功能衰竭患者行血液透析发生医院感染的病原菌分布及其临床特点,为减少血液透析室医院感染提供依据。方法回顾性分析2011年1月-2014年12月在医院进行血液透析的850例慢性肾功能衰竭患者的临床资料,按是否发生医院感染进行分组,感染组32例、非感染组818例,对感染患者的送检标本进行病原菌培养,对感染病原菌分布及患者临床特点、医院感染相关因素进行分析;采用SPSS18.0软件进行统计分析。结果 850例慢性肾功能衰竭血液透析患者中发生医院感染32例,感染率为3.76%;标本来源以痰液为主,占55.00%,其次为血液、尿液,分别占30.32%、10.97%;共分离出病原菌620例,其中革兰阳性菌分离出209株占33.71%,革兰阴性菌393株占63.39%,真菌18株占2.90%;感染组患者血红蛋白、血清白蛋白、血清球蛋白水平与非感染组比较,均显著性降低,差异均有统计学意义(P0.05);感染组患者CRP水平显著性高于非感染组(P0.05);年龄、贫血、透析龄、置管方式、心功能不全、低蛋白血症、糖尿病肾病等因素是慢性肾功能衰竭血液透析患者医院感染的危险因素(P0.05)。结论慢性肾功能衰竭血液透析患者医院感染病原菌种类较多,贫血、低蛋白血症、糖尿病肾病患者容易发生医院感染,临床应根据感染危险因素进行针对性干预。
[Abstract]:Objective to investigate the distribution and clinical characteristics of nosocomial infection in hemodialysis patients with chronic renal failure, and to provide a basis for reducing the nosocomial infection in hemodialysis room. Methods the clinical data of 850 patients with chronic renal failure in the hospital in December, January 2011 -2014 years, were analyzed retrospectively. The nosocomial infection was divided into groups, 32 cases of infection group and 818 cases of non infection group. The pathogenic bacteria were cultivated for the infected specimens. The distribution of pathogenic bacteria and the clinical characteristics of the patients and the related factors of hospital infection were analyzed. The SPSS18.0 software was used for statistical analysis. The result of 850 cases of chronic renal failure hemodialysis patients occurred. There were 32 cases of nosocomial infection, the infection rate was 3.76%, the source of the specimen was sputum, accounting for 55%, followed by blood and urine, accounting for 30.32%, 10.97%, and 620 cases were isolated, including 209 Gram-positive bacteria 33.71%, 63.39% Gram-negative bacteria, 63.39% and 18 fungus in 2.90%; infection group hemoglobin, serum albumin and serum egg. The white level was significantly lower than that in the non infected group, and the difference was statistically significant (P0.05); the CRP level in the infected group was significantly higher than that of the non infection group (P0.05); age, anemia, dialysis age, catheterization, cardiac insufficiency, hypoproteinemia, and diabetic nephrosis were the risk factors for the hospital infection in patients with chronic renal failure. The risk factors (P0.05). Conclusion there are many kinds of nosocomial pathogens in the patients with chronic renal failure Hemodialysis, anemia and hypoproteinemia, the patients with diabetic nephropathy are susceptible to nosocomial infection, and the clinical intervention should be based on the risk factors of infection.
【作者单位】：杭州市第一人民医院肾内科;杭州市第一人民医院急诊科;
【基金】：浙江省医药卫生科学基金资助项目(2004A018)
【分类号】：R692.5

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