急性冠脉综合征伴感染人群病原菌临床分布及相关因素分析

Clinical distribution of pathogens in acute coronary syndrome with infection and analysis of related factors

目的对急性冠脉综合征伴感染人群病原菌临床分布及相关因素分析。方法分析652例急性冠脉综合征患者资料,选取伴感染患者138例为观察组,514例未感染患者为对照组。结果感染率为13.4%,急性冠脉综合征伴感染患者单因素分析表明使用侵入性操作、糖尿病、康复训练、年龄(≥60岁)、抗菌素、心律失常、吸烟史、心功能分级(≥3级)、高血压、多壁心肌梗塞、住院时间、COPD与感染有关;多元逐步回归分析表明抗菌素、心功能分级、侵入性操作、多壁心肌梗塞、COPD、糖尿病、年龄与感染有关;致病菌191株;常见致病菌是革兰阴性杆菌106株(55.5%),以鲍氏不动杆菌、肠杆菌属、铜绿假单胞菌为主;革兰阳性球菌74株(38.7%),以金黄色葡萄球菌、表皮葡萄球菌、肠球菌属为主;真菌11株(5.8%),以白色假丝酵母菌为主。结论临床应尽早采取有效措施积极防控。

Objective To analyze the clinical distribution and related factors of pathogenic bacteria in patients with acute coronary syndrome(ACS).Methods The clinical data of 652 patients with acute coronary syndrome were analyzed.138 patients with infection were the observation group and 514 patients without infection were the control group.Results The infection rate was 13.4%.The single factor analysis of patients with acute coronary syndrome with infection showed that the use of invasive operation,accompanied by diabetes mellitus,early rehabilitation training,age(≥60 years old),antibiotics,arrhythmia,smoking history,cardiac function grade(>grade 3),hypertension,multi-wall myocardial infarction,length of hospital stay,COPD and other effects.Multiple stepwise regression analysis showed that antibiotics,grading of cardiac function,invasive operation,multi-wall myocardial infarction,COPD,diabetes mellitus and age were associated with infection;191 strains of pathogenic bacteria were detected;106 strains of Gram-negative(G-)bacilli(55.5%)were the most common pathogenic bacteria.Acinetobacter,Enterobacter and Pseudomonas aeruginosa were the main pathogens,followed by 74 Gram-positive(G+)cocci(38.7%)(Staphylococcus aureus,Staphylococcus epidermidis,Enterococcus)and 11 fungi(5.8%)(Candida albicans).Conclusion Effective measures should be taken to prevent and control ACS.