慢性乙型病毒性肝炎合并腹腔感染病原菌特征及危险因素分析

Analysis of pathogenic bacteria characteristics and risk factors of hepatitis B complicated with abdominal infection

目的探讨慢性乙型病毒性肝炎(以下简称乙肝)合并腹腔感染病原菌特征及危险因素。方法选取温州市中医院收治的116例慢性乙肝患者作为研究对象,将47例腹腔感染者纳入观察组,69例无腹腔感染者纳入对照组。采用χ2检验、多因素logistic回归分析慢性乙肝合并腹腔感染病原菌特征及危险因素。结果观察组中检出病原菌50株。其中,革兰氏阴性菌31株,占62.00%,以肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌为主;革兰氏阳性菌17株,占34.00%,以金黄色葡萄球菌、屎粪肠球菌为主;真菌2株,占4.00%。糖尿病(OR=3.387)、住院时间≥30 d(OR=5.643)、低蛋白血症(OR=3.156)、抗菌药物使用(多种)(OR=6.581)、有侵入性操作(OR=8.178)是慢性乙肝合并腹腔感染的独立危险因素(P<0.05)。结论慢性乙肝合并腹腔感染患者的致病菌以革兰氏阴性菌为主,糖尿病、住院时间≥30 d、低蛋白血症、使用多种抗菌药物、有侵入性操作是其独立危险因素。

Objective To investigate the pathogenic bacteria characteristics and risk factors of chronic hepatitis B complicated with abdominal infection.Methods A total of 116 patients with chronic hepatitis B admitted to Wenzhou Hospital of Traditional Chinese Medicine were selected as the research objects.47 patients with intra-abdominal infection were included in the observation group,and 69 patients without intra-abdominal infection were included in the control group.χ2test and multivariate logistic regression were used to analyze the pathogenic bacteria characteristics and risk factors of chronic hepatitis B complicated with abdominal infection.Results 50 strains of pathogenic bacteria were detected in the observation.Among them,31 strains of gram-negative bacteria were mainly Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa,accounting for 62.00%.17 strains of Gram-positive bacteria were mainly Staphylococcus aureus and Enterococcus faecium,accounting for 34.00%.2 strains of fungi accounted for 4.00%.Diabetes mellitus(OR=3.387),length of hospital stay≥30 days(OR=5.643),hypoproteinemia(OR=3.156),utilization of multiple antibiotics(OR=6.581)and invasive operation(OR=8.178)were independent risk factors for chronic hepatitis B complicated with abdominal infection(P<0.05).Conclusion Gram-negative bacteria was the main pathogenic bacteria in patients with chronic hepatitis B complicated with abdominal infection,while diabetes mellitus,hospital stay≥30days,hypoproteinemia,utilization of multiple antibiotics and invasive operation are the independent risk factors.