哮喘患儿医院感染病原菌分布及感染因素分析

Distribution of pathogenic bacteria causing infections in children with asthma and risk factors of infections

目的分析哮喘患儿医院感染病原菌及感染因素,为临床治疗及护理提供参考依据。方法对2010年1月-2012年12月医院收治的296例急性发作患儿进行痰培养以及单因素分析。结果共检出病原菌82株,其中革兰阳性菌占27.13%,主要是金黄色葡萄球菌16株;革兰阴性菌占73.17%,其中铜绿假单胞菌、流感嗜血菌、肺炎克雷伯菌、卡他莫拉菌分别为15、13、12、11株;真菌占3.66%,其中克柔假丝酵母菌2株,白色假丝酵母菌1株;共发生医院感染26例,占8.78%,主要为肺部感染占4.39%与气管支气管感染占3.38%;单因素分析结果显示,季节、年龄、住院时间、气管插管、气管切开、机械通气是患儿发生医院感染的主要因素(P<0.05)。结论铜绿假单胞菌、流感嗜血菌、肺炎克雷伯菌以及卡他莫拉菌等是哮喘患儿医院感染的病原菌,住院期间应加强对哮喘患儿的管理,尤其是伴易感因素的患儿,减少医院感染的发生。

OBJECTIVE To analyze the distribution of the pathogenic bacteria causing infections in the children with asthma and explore the risk factors for the infections so as to guide the clinical treatment and nursing.METHODS The sputum specimens were cultured for 296 children with acute asthma who were treated in the hospital from Jan 2010 to Dec 2012,then the univariate analysis was performed.RESULTS A total of 82strains of pathogens were isolated;the gram-positive bacteria accounted for 27.13%,among which there were 16strains of Staphylococcus aureus;the gram-negative bacteria accounted for 73.17%,among which there were 15strains of Pseudomonas aeruginosa,13 strains of Haemophilus influenzae,12 strains of Klebsiella pneumoniae,and 11strains of Moraxella catarrhalis;the fungi accounted for 3.66%,among which there were 2 strains of Candida krusei and 1strain of Candida albicans.The nosocomial infections occurred in 26（8.78%）cases,among which the cases with pulmonary infections accounted for 4.39%,the cases with tracheobronchial infections 3.38%.The univariate analysis indicated that the season,age,duration of hospitalization,intubation,tracheotomy,and mechanical ventilation were the main risk factors for the nosocomial infections in the children（P0.05）.CONCLUSION P.aeruginosa,H.influenzae,K.pneumoniae,and M.catarrhalis monocytogenes are the pathogens causing nosocomial infections in the children with asthma.It is necessary to strengthen the management of the children with asthma during the hospital stay,especially the children with susceptible factors,so as to reduce the incidence of nosocomial infections.