长期卧床患者下呼吸道感染病原菌分布和影响因素分析

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英文篇名：Analysis on influencing factors and distribution of pathogenic bacteria in patients with lower respiratory tract infection 作者：孙红岗 ; 何丽钦 ; 余诗怡 英文作者：SUN Hong-gang;HE Li-qin;YU Shi-yi;Shaoxing People's Hospital;Wenzhou Medical University; 关键词：卧床 ; 下呼吸道感染 ; 菌群分布 ; 影响因素 ; 临床对策 英文关键词：bedridden;;lower respiratory tract infection;;bacterial flora distribution;;influencing factors;;clinical countermeasures 中文刊名：ZGXD 英文刊名：Chinese Journal of Disinfection 机构：绍兴市人民医院;温州医科大学; 出版日期：2019-06-15 出版单位：中国消毒学杂志 年：2019 期：v.36;No.214 基金：浙江大学绍兴市人民医院青年学者基金(2017B15) 语种：中文; 页：ZGXD201906012 页数：3 CN：06 ISSN：11-2672/R 分类号：42-44

摘要

目的探索绍兴市人民医院康复科收治的长期卧床患者下呼吸道感染病原菌群分布及影响因素。方法运用回顾性分析方法对2015年1月-2017年12月的145例长期卧床患者的下呼吸道感染病原菌群分布进行分析;运用Logistic回归对各影响因素进行分析。结果分离出的145株病原菌中革兰阴性菌占59. 31%,其中前5位的分别是肺炎克雷伯菌、绿脓假单胞菌、鲍曼不动杆菌、大肠埃希菌和阴沟肠杆菌;革兰阳性菌占33.10%,其中前4位的分别是溶血葡萄球菌、金黄色葡萄球菌、表皮葡萄球菌和肠球菌;真菌占7. 59%。对长期卧床患者进行单因素分析发现,患病年龄、住院天数、基础疾病、卧床天数、有创操作、抗菌药物应用、昏迷和激素应用是下呼吸道感染的危险因素,多因素分析发现影响长期卧床患者下呼吸道感染的危险因素由强到弱分别是卧床天数、年龄、基础疾病、住院时间、昏迷、抗菌药物应用和有创操作。结论条件致病菌是造成长期卧床患者下呼吸道感染的主要致病菌;卧床天数、年龄、基础疾病、住院时间、昏迷、抗菌药物应用和有创操作是影响长期卧床患者下呼吸道感染的独立危险因素。
        Objective To explore the influencing factors and distribution of pathogenic bacteria in long-term bedridden patients with lower respiratory tract infection from department of rehabilitation in Shaoxing people ' s hospital.Methods Retrospective analysis was used to analyze the distribution of pathogenic bacteria in 145 long-term bedridden patients with lower respiratory tract infection from January 2015 to December 2017,and the influencing factors were analyzed by Logistic regression. Results Gram-negative bacteria accounted for 59. 31%,of which the top five bacteria were Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,Escherichia coli and Enterobacter cloacae. Gram-positive bacteria accounted for 33. 10%,of which the top four bacteria were Staphylococcus haemolyticus,Staphylococcus aureus,Staphylococcus epidermidis and Enterococcus. Fungi accounted for 7. 59%. Univariate analysis of long-term bedridden patients showed that age,hospitalization time,underlying diseases,bedridden days,invasive operation,antibiotic use,coma,hormone application were risk factors of lower respiratory tract infection. Multivariate analysis showed that the risk factors for lower respiratory tract infection in long-term bedridden patientswere bedridden days,age,underlying diseases,hospitalization time,coma,antibiotic use,invasive operation,from strong to weak respectively. Conclusion Conditional pathogenic bacteria are the main pathogens causing lower respiratory tract infection in long-term bedridden patients. Bedridden days,age,underlying diseases,hospitalization time,coma,antibiotic use,invasive operation were independent risk factors of lower respiratory tract infection in long-term bedridden patients.

引文

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