深圳24例H7N9患者合并细菌感染危险因素分析

Risk factors for bacterial infection of 24 H7N9 inpatients in Shenzhen

目的 分析H7N9住院患者发生细菌感染的危险因素,为防控H7N9患者合并细菌感染提供依据.方法 回顾性分析2013年12月-2014年5月在24例深圳H7N9住院患者的临床资料,细菌感染的病原菌分布及药敏.结果 共发生10例细菌感染,总体感染率为41.7％,发生部分最常见于肺部（10/10）.共分离出革兰氏阴性菌20株占64.5％,革兰氏阳性菌11株占35.5％.7例患者发生广泛耐药鲍曼不动杆菌感染.H7 N9患者发生细菌感染的危险因素为未及时抗病毒治疗,有创呼吸机的使用,重症ARDS,淋巴细胞、CD4＋T细胞、氧合指数显著减低,淋巴细胞持续减少.结论 H7N9患者细菌感染发生率高,影响因素多,应针对以上影响因素采取相应的防控措施,提倡早期抗病毒治疗,以有效降低细菌感染的发生.

Objective To investigate the risk factors for bacterial infection of H7N9 inpatients,and provide reference for the prevention of bacterial infection.Methods The clinical and bacterial infection data in 24 H7N9 infections in Shenzhen from Dec 2013 to May 2014 was retrospectively analyzed.Results A total of 10 cases were infected with an infection rate of 41.7%.The lung was the main infected sites.Of all the bacteria isolated,there were 20 strains of gram-negative bacillus （64.5%）,11 strains of grampositive cocci （35.5%）.7 patients encountered extensively drug resistant acinetobacter baumannii.The risks factors for bacterial infection of H7N9 inpatients were delayed antiviral therapy,invasive mechanical ventilation,severe ARDS,lower lever of lymphocytes,CD4 ＋ cells and oxygenation indexes,persistent lymphocytopenia.Conclusions The incidence of bacterial infection in H7N9 patients is relatively high;there are so many risk factors that we should take corresponding measures to effectively reduce the incidence.