社区获得性肺炎并发革兰阴性菌感染的病原菌分布及危险因素分析

Analysis of Pathogenic Bacteria Distribution and Risk Factors in Community Acquired Pneumonia Complicated by Gram Negative Bacteria Infection

目的:探讨社区获得性肺炎(CAP)并发革兰阴性菌感染的病原菌分布及危险因素,以降低感染率。方法:选择2013年6月到2015年6月我院确诊CAP患者80例,收集所有患者的临床资料,分析CAP并发革兰阴性菌感染的病原菌分布及危险因素。结果:CAP并发革兰阴性菌感染的病原菌以肺炎克雷伯菌株数最多,13株(占30.23%),其次为大肠埃希菌8株(占18.60%)和鲍曼不动杆菌7株(占16.28%)。感染阳性组入院治疗前使用抗生素、白细胞水平异常、PORT≥3级以及血尿素氮水平>7.1 mmol/L的比例较感染阴性组显著更高,差异均有统计学意义(均P<0.05)。由Logistic回归分析可知,入院治疗前使用抗生素、白细胞水平异常、PORT≥3级以及血尿素氮水平>7.1 mmol/L均为影响CAP患者发生革兰阴性菌感染的危险因素。结论:CAP并发革兰阴性菌感染的病原菌主要以肺炎克雷伯菌,大肠埃希菌和鲍曼不动杆菌为主,临床上应重视CAP并发革兰阴性菌感染危险因素,以降低感染率。

To discuss pathogenic bacteria distribution and risk factors in community acquired pneumonia complicated with infection of gram negative bacteria, and to reduce the infection rate. Methods： Chose 80 patients with CAP who were diagnosed as CAP in our hospital from June 2013 to June 2015, collected the clinical data of CAP patients.The clinical characteristics and risk factors of gram negative bacterial infection were analyzed. Results： CAP complicated with infection of gram negative bacteria with Klebsiella pneumoniae trees was the most, 13 strains（accounted for 30.23%）, followed by 8 strains of Escherichia coli（accounted for 18.6%） and 7strains of Bormann real coli（accounted for 16.28%）. Infection positive group＇s the use of antibiotics before hospitalized, abnormal levels of white blood cells, PORT≥3 and level of blood urea nitrogen7.1 mmol/L proportion were significantly higher, the differences were statistically significant（P〈0.05）. With logistic regression analysis showed the use of antibiotics before hospitalized, abnormal levels of white blood cells, PORT≥3 and level of blood urea nitrogen7.1 mmol/L was gram negative bacteria infection risk factors. Conclusion：The pathogenic bacteria of CAP complicated by Gram negative bacteria infection in patients is mainly caused by pneumonia, Escherichia coli and Bauman Acinetobacter. The main clinical treatment should pay attention to the risk factors of infection caused by CAP infection,so as to reduce the infection rate.