摘要
目的探究抗中性粒细胞胞质抗体(ANCA)相关性血管炎(AAV)并发感染病原学及危险因素。方法回顾性分析2021年5月-2023年5月湛江中心人民医院收诊的151例AAV患者临床资料,其中并发感染79例为感染组、未并发感染72例为非感染组。统计AAV患者并发感染现况及病原体分布,通过Logistic回归分析法分析AAV患者并发感染的危险因素。结果果151例AAV患者并发感染79例,并发感染发生率为52.32%;感染组患者分离81株病原体,包括革兰阴性菌、革兰阳性菌、真菌及病毒;其中革兰阴性菌占比最高,以铜绿假单胞菌为主,革兰阳性菌占比次之,以金黄色葡萄球菌为主。Logistic回归分析结果显示,肺部受累、胃肠道受累、血红蛋白、白蛋白是AAV患者并发感染的危险因素(P<0.05)。结论AAV患者并发感染的发生率高,病原菌以革兰阴性菌为主,且可引起实验室血红蛋白、白蛋白、肾小球滤过率(eGFR)及血肌酐水平指标异常;肺部受累、胃肠道受累、血红蛋白、白蛋白与AAV患者并发感染密切相关;临床可据此予以早期针对性防治而降低AAV患者并发感染风险。
OBJECTIVE To explore the etiological characteristics and risk factors for infections in the patients with anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV).METHODS A total of 151 patients with AAV who were treated in Zhanjiang Central People's Hospital from May 2021 to May 2023 were enrolled in the study,79 of whom were complicated with infection and were assigned as the infection group,72 were not complicated with infection and were assigned as the non-infection group.The clinical data of the patients were ret-rospectively analyzed.The prevalence of infections and distribution of pathogens isolated from the AAV patients were statistically analyzed.Logistic regression analysis was performed for the risk factors for the infections in the AAV patients.RESULTS Totally 79 patients were complicated with infections among the 151 AAV patients,with the incidence of infections 52.32%.Totally 81 strains of pathogens were isolated from the patients of the infection group,including gram-negative bacteria,gram-positive bacteria,fungi and viruses.The gram-negative bacteria were dominant among the isolated pathogens,followed by the gram-positive bacteria,Pseudomonas aeruginosa was the predominant species of gram-negative bacteria,and Staphylococcus aureus was the major species of grampositive bacteria.The result of logistic regression analysis showed that lung involvement,gastrointestinal tract involvement,hemoglobin and albumin were the risk factors for the infections in the AAV patients(P<0.05).CONCLUSION The incidence of infections is high among the AAV patients,the gram-negative bacteria are dominant among the pathogens.The infections may result in the abnormal changes of clinical laboratory test indexes hemoglobin,albumin,glomerular filtration rate(eGFR).The infections in the AAV patients are closely associated with the lung involvement,gastrointestinal involvement,hemoglobin and albumin.It is necessary for the hospital to take targeted prevention and control measures in early stage so as to reduce the
作者
杨蕾
邱瑾
许景宁
郑华才
张家明
YANG Lei;QIU Jin;XU Jing-ning;ZHENG Hua-cai;ZHANG Jia-ming(Zhanjiang Central People's Hospital,Zhanjiang,Guangdong 524037,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第13期1928-1932,共5页
Chinese Journal of Nosocomiology
基金
广东省医学科研基金资助项目(A2020379)
湛江市科技专项基金资助项目(2023B01089)。
关键词
抗中性粒细胞胞质抗体
相关性血管炎
并发感染
病原菌
危险因素
Anti-neutrophil cytoplasmic antibody
Associated vasculitis
Complicated infection
Pathogen
Risk factor
