摘要
目的分析医院获得性铜绿假单胞菌血流感染的临床特征及死亡相关因素,为临床诊治提供参考依据。方法回顾性分析医院2010年1月-2011年12月由铜绿假单胞菌引起的医院获得性血流感染患者临床资料,根据是否暴露于危险因素进行死亡相关单因素及多因素分析,单因素分析分别比较不同危险因素之间死亡率的差异,多因素分析采用logistic回归分析。结果 51例血流感染患者98.0%出现发热,72.5%伴寒颤;31.4%有血液系统疾病,白细胞、中性粒细胞低于正常值,余患者中97.1%白细胞或(和)中性粒细胞升高;37.3%为导管相关性血流感染,35.3%发生感染性休克;病死率为29.4%,死亡相关单因素分析显示,年龄≥70岁、糖尿病、心脏疾病、肺部感染、血白蛋白<30g/L、血红蛋白<90g/L、有创机械通气、血液透析、入住ICU与死亡相关;logistic回归分析显示,糖尿病、血红蛋白<90g/L是死亡相关因素。结论医院获得性铜绿假单胞菌血流感染多伴有发热、寒颤、白细胞或(和)中性粒细胞升高,糖尿病、血红蛋白<90g/L为死亡相关因素。
OBJECTIVE To study the clinical characteristics and factors associated with mortality of nosocomial bloodstream infections due to Pseudomonas aeruginosa so as to provide reference for the clinical diagnosis and treatment.METHODS The clinical data of the patients with bloodstream infections caused by P.aeruginosa from Jan 2010 to Dec 2011 were analyzed retrospectively.According to the exposure to the risk factors,both the univariate factor analysis and the multivariate analysis were performed for the risk factors associated with the mortality.The univariate analysis was performed by comparing the mortality due to the various risk factors between the two groups,and logistic regression analysis was performed to analyze the multiple factors.RESULTS Of totally 51 patients with bloodstream infections,98.0% of the patients had fever,72.5% with rigor,and 31.4% with hematologic disease and low white blood cell counts and low neutrophilic granulocyte counts.Of the rest of the patients,there were 97.1% of the patients with the white blood cell counts or/and the neutrophilic granulocyte counts elevated,37.3% with catheter-related bloodstream infections.There were 35.3% of the patients complicated by septic shock,and the overall mortality rate was 29.4%.The univariate analysis of the mortality-associated factors indicated that the mortality was correlated with the more than 70 years of age,diabetes mellitus,heart disease,pulmonary infection,blood ALB30 g/L,blood HGB90 g/L,invasive mechanical ventilation,hemodialysis,and the ICU stay.The logistic regression analysis indicated that the diabetes mellitus and blood HGB90 g/L were related to the mortality.CONCLUSION The patients with hospital-acquired P.aeruginosa bloodstream infections are usually complicated by the fever,rigor,and the elevated white blood cell counts or/and neutrophilic granulocyte counts.The diabetes mellitus and blood HGB90 g/L are the related factors for the mortality.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第3期511-513,共3页
Chinese Journal of Nosocomiology
关键词
铜绿假单胞菌
医院获得性血流感染
死亡相关因素
Pseudomonas aeruginosa
Hospital-acquired bloodstream infections
Faetors associated with mortality
