摘要
目的探讨肾功能衰竭并发医院获得性感染患者致病菌的分布和耐药特点,以及患者血清白细胞介素10(IL-10)基因多态性与细菌耐药的相关性。方法选取肾功能衰竭患者165例,统计其医院获得性感染的发生率及类型、病原菌的分布情况,并分析主要感染病原菌的细菌耐药情况。根据细菌多重耐药情况将患者分为耐药组及非耐药组,分析两组患者血清IL-10中rs1800871、rs1800872及rs1800896位点基因多态性与细菌耐药的相关性。结果(1)肾功能衰竭患者医院获得性感染的发生率为54.55%(90/165),常见的感染类型为肺部感染和尿路感染。(2)感染病原菌以革兰阴性菌为主,占比为59.26%(64/108),其中以铜绿假单胞菌感染为主;其次为革兰阳性菌,占比为29.63%(32/108),其中以金黄色葡萄球菌感染为主。铜绿假单胞菌对头孢曲松、亚胺培南及头孢他啶的耐药率较高,金黄色葡萄球菌对苯唑西林的耐药率较高。(3)多重耐药发生率为12.04%(13/108),患者血清IL-10基因rs1800896位点的AA及GG基因型与细菌多重耐药相关(均P<0.05),其中AA基因型为抗生素治疗的有利因素,GG基因型为抗生素治疗的不利因素。结论肾功能衰竭患者并发医院获得性感染的概率较高,病原菌以铜绿假单胞菌和金黄色葡萄球菌为主,且多重耐药率较高,选择治疗方案时应以患者的药敏结果及肾功能指标为参考,合理选择抗菌药物;患者血清IL-10的rs1800896基因多态性与细菌多重耐药相关。
Objective To explore the pathogenic bacteria distribution and drug resistance characteristics in renal failure patients complicated with nosocomial infection, as well as the correlation between serum interleukin 10(IL-10) gene polymorphism and bacterial drug resistance in the patients.Methods A total of 165 patients with renal failure were selected, and the incidence and type of nosocomial infection and the distribution of pathogenic bacteria in the patients were counted;besides, the prevalence of bacterial drug resistance to major pathogenic bacteria was analyzed. The patients were divided into drug-resistant group and non-drug-resistant group according to the prevalence of bacterial multidrug resistance. The correlations of gene polymorphisms of loci rs1800871, rs1800872, and rs1800896 in serum IL-10 with bacterial drug resistance were analyzed in the two groups. Results(1)Patients with renal failure yielded an incidence of nosocomial infection of 54.55%(90/165), and the common infections were pulmonary infection and urinary tract infection.(2)Gram-negative bacteria were the main pathogenic bacteria, accounting for 59.26%(64/108), among which Pseudomonas aeruginosa infection was dominant;followed by gram-positive bacteria accounting for 29.63%(32/108), among which Staphylococcus aureus infection was dominant. Pseudomonas aeruginosa had higher rates of drug resistance to ceftriaxone, imipenem and ceftazidime. Staphylococcus aureus had higher rates of drug resistance to oxacillin.(3)The incidence of multidrug resistance was 12.04%(13/108), and AA and GG genotypes in serum IL-10 gene locus rs1800896 correlated with bacterial multidrug resistance in the patients(all P<0.05), wherein the AA genotype was a favorable factor for antibiotic treatment, while the GG genotype was an unfavorable factor for antibiotic treatment. Conclusion Patients with renal failure have a relatively high probability of concomitant nosocomial infection, the pathogenic bacteria are dominated by Pseudomonas aeruginosa and Staphylococcus aureu
作者
黄诗斯
李芬
廖晓梅
彭玉凤
HUANG Shi-si;LI Fen;LIAO Xiao-mei;PENG Yu-feng(Laboratory Medicine Center,the First People′s Hospital of Chenzhou City,Chenzhou 423000,China)
出处
《广西医学》
CAS
2022年第7期760-765,共6页
Guangxi Medical Journal
基金
湖南省郴州市第一人民医院院内教改项目(CJG2020-3)。
