肿瘤科住院患者感染大肠埃希氏菌的特征分析

Characteristic Analysis of Escherichia Coli from Inpatients in Department of Oncology

目的:总结肿瘤科住院患者感染大肠埃希氏菌的临床特征,分析发生医院感染的危险因素,为临床治疗和加强医院感染的预防提供依据。方法:收集2015年4月-2016年12月肿瘤科住院发生医院感染的恶性肿瘤患者的临床资料,采用回顾性方法查阅感染患者的电子病历,对感染病原菌的标本来源、肿瘤病种及导致感染的相关危险因素进行分析,相关危险因素分析采用字2检验和多因素Logistic回归模型。结果:临床送检标本中检出病原菌245株,其中大肠埃希氏菌62株,检出率为25.3%,感染大肠埃希氏菌的主要标本是尿液,占59.7%,送检标本病种分布以宫颈癌为主,占54.8%。感染大肠埃希氏菌患者放化疗、留置尿管、女性比例多于未感染患者,差异均有统计学意义(P<0.05)。多因素回归分析显示留置尿管、放化疗是大肠埃希氏菌感染的独立危险因素(P<0.05)。结论:大肠埃希氏菌感染在宫颈癌患者中发生率高,加强肿瘤患者放化疗期间和留置导尿期间的管理,可减少大肠埃希氏菌的感染。

Objective：To summarize the clinical characteristics of inpatients infected with the Escherichia coli in the oncology department,analyze the risk factors of nosocomial infection,and provide a basis for clinical treatment and prevention of nosocomial infection.Method： Collected the clinical data of malignant tumor patients who infected with the Escherichia coli in the oncology department during the period from April 2015 to December 2016,consulted their electronic medical record by retrospective method,analyzed sample source of pathogenic bacteria infection,tumor type,and the related risk factors of leading to infection,the analysis of related risk factors were performed by Chi square test and the multiple factors Logistic models.Result： In all clinical samples,245 strains of pathogenic bacteria were detected,including 62 strains of the Escherichia coli,relevance ratio was 25.3%.The samples infected the Escherichia coli mainly urine,accounted for 59.7%;disease distribution of tumor samples mainly was cervical cancer,accounted for 54.8%.The rate of chemoradiotherapy,indwelling catheter,and female in patients infected with Escherichia coli were higher than that of non infected patients,the differences were statistically significant（P〈0.05）.The multiple factors Logistic analysis revealed that indwelling catheter and chemoradiotherapy were the independent risk factors of the Escherichia coli infection （P〈0.05）.Conclusion： The occurrence rate of the Escherichia coli infection was high in cervical cancer patients,the reinforced management for the tumor patients who in the period of after-loading radiotherapy and the tumor patients with indwelling catheter could reduce the Escherichia coli infection.