糖尿病住院患者医院感染病原菌分布及炎症因子变化情况研究

发布时间：2018-05-11 15:33

本文选题：糖尿病 + 医院感染　；参考：《中华医院感染学杂志》2017年23期

【摘要】：目的调查糖尿病住院患者的医院感染情况、对患者的病原菌构成情况进行分析,并掌握感染患者的炎症因子变化情况为临床实践提供参考依据。方法选取2015年10月-2016年9月期间医院临床收治的糖尿病住院患者844例,统计糖尿病住院患者的医院感染情况,采用单因素分析和多因素回归的分析方法统计分析导致糖尿病患者医院感染发生的危险因素,并对患者的血清样本进行病原菌检测,同时对感染患者和非感染患者的相关血清炎症因子指标水平进行比较研究。结果 844例糖尿病住院患者中有116例患者发生医院感染,感染率为13.74%;116例糖尿病住院感染患者共检出病原菌168株,其中革兰阴性菌122株占72.62%、革兰阳性菌37株占22.02%、真菌9株占5.36%;多因素分析结果显示:年龄、住院时间、病程、空腹血糖、抗菌药物使用、侵入操作是导致糖尿病住院患者感染的独立危险因素(P0.05);感染患者的补体C3、C4,降钙素原(PCT)、C-反应蛋白(CRP)及白细胞(WBC)等指标高于非感染患者,感染患者的CD_3~+ CD_4~+和CD_3~+ CD_8~+低于非感染患者(P0.05)。结论糖尿病住院患者的医院感染情况应引起临床重视,导致患者感染的病原菌以革兰阴性菌为主,患者感染后的相关临床因子会发生异常改变。
[Abstract]:Objective to investigate the nosocomial infection in patients with diabetes mellitus, to analyze the pathogenic bacteria composition of the patients, and to understand the changes of inflammatory factors in the patients with diabetes mellitus, and to provide reference for clinical practice. Methods from October 2015 to September 2016, 844 patients with diabetes mellitus were selected, and the nosocomial infection of the patients with diabetes mellitus was analyzed. Single factor analysis and multivariate regression analysis were used to analyze the risk factors of nosocomial infection in diabetic patients. At the same time, the levels of serum inflammatory cytokines in infected patients and non-infected patients were compared. Results among 844 patients with diabetes mellitus, 116 cases had nosocomial infection, and the infection rate was 13.74%. A total of 168 strains of pathogenic bacteria were detected in 116 cases of diabetes inpatients. Among them, 122 strains of Gram-negative bacteria accounted for 72.62%, 37 strains of Gram-positive bacteria accounted for 22.02% and 9 strains of fungi accounted for 5.36.The results of multivariate analysis showed that age, length of stay, course of disease, fasting blood glucose, use of antimicrobial agents, Invasion was an independent risk factor for infection in hospitalized patients with diabetes mellitus (P 0.05), and the indexes of complement C3C4, procalcitonin (PCT) C-reactive protein (CRP) and white blood cell (WBCC) in infected patients were higher than those in non-infected patients. CD3 ~ CDS4 ~ and CD3 ~ CD8 ~ in infected patients were lower than those in non-infected patients (P0.05). Conclusion Clinical attention should be paid to the nosocomial infection in patients with diabetes mellitus. Gram-negative bacteria are the main pathogens leading to the infection, and the related clinical factors will change abnormally after infection.
【作者单位】：杭州市余杭区第一人民医院内分泌科;杭州市余杭区第一人民医院检验科;
【分类号】：R446.5;R587.1

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