肛周脓肿患者病原菌分布及多重耐药菌感染的危险因素分析
Analysis of Distribution of Pathogenic Bacteria and Risk Factors of Multiple Resistant Bacterial Infection in Patients with Perianal Abscess
冯娜 1程燕洁 1李乐维1
作者信息
- 1. 河南中医药大学第五临床医学院(郑州人民医院)检验科(河南郑州 450000)
- 折叠
摘要
目的:分析肛周脓肿患者病原菌分布及多重耐药菌感染的危险因素.方法:选取2021年1月至2023年3月我院收治的68例肛周脓肿患者为研究参与者,收集患者的脓液样本以及病灶深部分泌物进行病原菌的分离、鉴定和药敏试验.对病原菌的分布进行统计分析,采用单因素和多因素分析影响肛周脓肿患者多重耐药菌感染的危险因素.结果:对68例肛周脓肿患者的脓液样本进行检测,其中细菌培养阳性61例(89.71％).阳性培养结果中检测到95株细菌,其中78株(82.11％)为革兰阴性菌,以大肠埃希菌(66株,69.47％)、肺炎克雷伯菌(7株,7.37％)为主要细菌种类,对亚胺培南、美罗培南耐药性低,敏感度高.17株(17.89％)为革兰阳性菌,以金黄色葡萄球菌(6株,6.32％)、粪肠球菌(5株,5.26％)为主,对利奈唑胺、万古霉素均敏感.在61例检出病原菌感染的患者中,46例(75.41％)存在多重耐药菌感染.Logistic回归分析显示,合并糖尿病(OR=1.515,P=0.001)、慢性腹泻史(OR=1.780,P＜0.001)、反复使用抗生素史(OR=1.718,P＜0.001)、抗生素种类(OR=1.667,P＜0.001),抗生素使用时间(OR=1.593,P＜0.001)是影响肛周脓肿患者多重耐药菌感染的独立危险因素.结论:肛周脓肿患者主要是革兰氏阴性细菌感染,大肠埃希菌和肺炎克雷伯菌为主要致病菌.同时,合并患有糖尿病、长期腹泻病史、频繁使用抗生素、抗生素种类和使用时长等因素均与患者多重耐药菌感染的风险有关.
Abstract
Objective To analyze the distribution of pathogenic bacteria and the risk factors of multiple resistant bacterial infection in patients with perianal abscess.Methods Total 68 patients with perianal abscess admitted to our hospital from January 2021 to March 2023 were selected as study participants.The pus samples and deep secretions of the lesions were collected for the separation,identification and drug sen-sitivity test of pathogenic bacteria.The distribution of pathogenic bacteria was statistically analyzed,and the risk factors affecting the infection of multiple resistant bacteria in patients with perianal abscess were analyzed by univariate and multivariate analysis.Results The pus samples of 68 patients with perianal abscess were detected,and 61 cases(89.71％)were positive for bacterial culture.Total 95 strains of bacte-ria were detected in the positive culture results,of which 78 strains(82.11％)were gram-negative bacteri-a,with Escherichia coli(66 strains,69.47％)and Klebsiella pneumoniae(7 strains,7.37％)as the main bacteria species,with low resistance and high sensitivity to imipenem and meropenem.Total 17 strains(17.89％)were gram-positive bacteria,with Staphylococcus aureus(6 strains,6.32％)and Enterococcus faecalis(5 strains,5.26％)as the main bacteria,sensitive to linezolid and vancomycin.In 61 patients with detected pathogenic bacterial infection,total 46 cases(75.41％)had multiple resistant bacterial infection.Logistic regression analysis showed that patients suffered from diabetes(OR=1.515,P=0.001),a long history of diarrhea(OR=1.780,P＜0.001),frequent use of antibiotics(OR=1.718,P＜0.001),antibi-otic types(OR=1.667,P＜0.001),duration of antibiotic usage(OR=1.593,P＜0.001)were independ-ent risk factors affecting multiple resistant bacterial infection in patients with perianal abscess.Conclu-sion Patients with perianal abscess are mainly infected by gram-negative bacteria,and Escherichia coli and Klebsiella pneumoniae are the main pathogenic bacteria.At the same time,patients suffered from diabetes or a long history of diarrhea,frequent use of antibiotics,antibiotic types,and duration of antibiotic usage,etc.are associated with the risk of multiple resistant bacterial infection.
关键词
肛周脓肿/病原菌/耐药性/危险因素Key words
Perianal abscess/Pathogenic bacteria/Resistance/Risk factors引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据