菌血症患者感染危险因素分析

Analysis on risk factors for the patients with bacteremia

目的探讨菌血症患者的相关危险因素,以降低菌血症的发生率。方法收集2012年12月-2013年8月菌血症患者174例,对其性别、基础疾病、科室、细菌种类、其他部位感染、是否进行中心静脉插管等资料进行回顾性分析,所有数据采用SPSS13.0软件进行统计分析。结果 174例菌血症患者的基础疾病主要为恶性血液病、实体肿瘤和淋巴瘤,分别占48.85%、20.69%和9.77%;居前5位的科室分别是移植科、血液科、消化道肿瘤区、淋巴头颈部肿瘤区、ICU,分别占35.63%、16.09%、10.34%、8.62%、6.90%;89例患者同时存在其他部位的感染,78例进行了中心静脉置管;在中心静脉置管的患者中16例同时进行了导管培养,送检率为20.51%,导管培养阳性12例,阳性率为75.00%;12例明确诊断为导管相关性血流感染;血标本及导管检出病原菌202株,大肠埃希菌居首位,占21.78%,所有标本共检出病原菌406株,血标本与所有标本分离细菌排序基本一致。结论恶性基础疾病、其他部位感染、中心静脉导管置入等为菌血症感染的高危因素,应加强对相关患者菌血症感染的预防与控制。

OBJECTIVE To explore the risk factors associated with bacteremia ,so as to reduce the infection rate of the bacteremia .METHODS During the period of Dec .2012 to Aug .2013 ,174 patients with bacteremia were analyzed on gender ,underlying diseases ,departments ,bacterial species ,other sites of infection ,whether central venous catheter was implemented or not ,etc .SPSS 13 .0 software was used for statistical analysis .RESULTS The underlying diseases of 174 patients with bacteremia were mainly hematological malignancies ,solid tumors and lymphoma ,and accounted for 48 .85% , 20 .69% and 9 .77% respectively ;the top five departments were transplanted department （35 .63% ） , hematology department （16 .09% ） , gastrointestinal cancer department （10 .34% ） ,lymph tumor of head and neck department （8 .62% ） and ICU （6 .90% ） .There were 89 patients with other sites of infection and 78 patients with central venous catheter at the same time .The catheters of 16 cases were cultured simultaneously ,and detection rate was 20 .51% .The catheter culture of 12 cases was positive ,and the positive rate was 75 .00% .A total of 12 cases got diagnosis of catheter-related blood stream infection .Among 202 strains bacteria isolated from blood samples , Escherichia coli was separated in the first place accounted for 21 .78% strains ,while 406 strains bacteria isolated from all kinds of specimens .The list of ranking of the bacteria isolated from blood samples was consistent with that from all kinds of specimens .CONCLUSIONS Malignant underlying diseases , other sites of infections and central venous catheter infections are the risk factors for bacteremia .The prevention and control measures on the patients with risk factors above should be strengthened .