摘要
目的分析胆道疾病患者胆道感染的病原学特征及危险因素。方法回顾性分析2016年1月-2019年9月在浙江省舟山妇幼保健院收治的112例胆道疾病并发胆道感染患者的临床资料,此组患者为感染组,进而根据疾病类型分为良性胆道疾病感染82例和恶性胆道疾病感染30例。另以同期医院收治的112例胆道疾病未并发胆道感染患者为未感染组。回顾性分析患者入院的年龄、性别、体质量指数(BMI)、基础疾病、胆道疾病类型、是否存在既往胆道手术史等一般资料;全自动微生物分析仪进行病原菌鉴定和耐药性检测;Logistic回归分析影响良恶性胆道疾病患者胆道感染的危险因素。结果112例胆道疾病并发胆道感染患者共分离134株病原菌,良性胆道疾病感染患者病原菌以革兰阴性菌(67.02%)为主,恶性胆道疾病感染患者病原菌以革兰阴性菌(72.50%)为主;恶性胆道疾病感染患者革兰阴性分离菌株对常用抗菌药物的耐药率高于良性胆道疾病感染患者(P<0.05);年龄增加(OR=1.891,P=0.026)、恶性胆道疾病感染(OR=2.065,P=0.003)和有既往胆道手术史(OR=1.900,P=0.024)均为影响患者胆道感染的独立危险因素。结论良恶性胆管疾病患者感染病原菌均以革兰阴性菌为主,临床可优先选择相对敏感的万古霉素、阿米卡星等药物治疗,重点关注年龄较大、存在既往胆道手术史和恶性胆道疾病患者的病情发展。
OBJECTIVE To investigate the etiological characteristics and risk factors for biliary tract infection in the patients with biliary diseases.METHODS Totally 112 biliary disease patients who were complicated with biliary tract infection and treated in Zhoushan Maternal and Child health Hospital from Jan 2016 to Sep 2019 were chosen as the infection group,82 of whom had benign biliary disease,and 30 had malignant biliary disease;the clinical data of the patients were retrospectively analyzed.Meanwhile,112 biliary disease patients who were not complicated with biliary tract infection were chosen as the non-infection group.The baseline data of the patients,including the age at admission,gender,body mass index(BMI),underlying disease,type of biliary disease and previous history of biliary surgery,were retrospectively analyzed,the pathogens were identified by using automatic microorganism analyzer,the drug resistance was analyzed,and logistic regression analysis was performed for the risk factors for the biliary tract infection in the patients with malignant biliary diseases.RESULTS A total of 134 strains of pathogens were isolated from the 112 biliary disease patients complicated with biliary tract infection.The gram-negative bacteria accounted for 67.02%among the pathogens isolated from the patients with benign biliary disease,and the gram-negative bacteria accounted for 72.50%among the patients with malignant biliary diseases.The drug resistance rates of the gram-negative bacteria isolated from the patients to commonly used antibiotics were significantly higher than those of the strains isolated from the patients with benign biliary disease(P<0.05).The increase of age(OR=1.891,P=0.026),malignant biliary tract disease(OR=2.065,P=0.003)and previous history of biliary disease(OR=1.900,P=0.024)were the independent risk factors for the biliary tract infection.CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the patients with benign and malignant biliary diseases.It is necessary for the
作者
李松财
汤武亨
金海
陈圆
曹春宇
LI Song-cai;TANG Wu-heng;JIN Hai;CHEN Yuan;CAO Chun-yu(Zhoushan Maternal and Child health Hospital Zhoushan,Zhejiang 316000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第21期3321-3325,共5页
Chinese Journal of Nosocomiology
基金
舟山市科技计划基金资助项目(2017C31119)。
关键词
胆道疾病
病原菌
耐药性
危险因素
Biliary disease
Pathogen
Drug resistance
Risk factor
