中医水蛭疗法相关皮肤及软组织感染风险

Risk of skin and soft tissue infection related to Chinese medicine leech therapy

目的探讨接受中医水蛭疗法的患者发生皮肤及软组织医院感染的风险。方法回顾性收集某院风湿病科2021年1月1日—12月31日接受中医水蛭疗法(治疗组)的住院患者100例与同期未接受水蛭疗法(非治疗组)患者666例的临床资料,比较两组患者皮肤与软组织感染发生率,通过病原学培养寻找水蛭携带的潜在病原菌。结果治疗组和非治疗组患者各发生皮肤及软组织医院感染1例,医院感染发病率分别为1.0%、0.2%,两组比较差异无统计学意义(P=0.244)。采集30份水蛭体表和营养液标本,29份(96.7%)检出粪产碱菌和雷氏普罗威登斯菌。结论中医水蛭疗法导致皮肤及软组织感染的风险较低,但水蛭体表及营养液常被条件致病菌污染,加强治疗后的感染控制及监测感染情况依然重要。

Objective To evaluate the risk of healthcare-associated infection(HAI)of skin and soft tissue in patients receiving Chinese medicine leech therapy.Methods Clinical data of 100 hospitalized patients who received Chinese medicine leech therapy(therapy group)from January 1 to December 31,2021 in the rheumatology department of a hospital and 666 patients who didn’t receive leech therapy(non-therapy group)during the same period were collected retrospectively,incidence of skin and soft tissue infection between two groups of patients was compared,and the potential pathogens carried by leeches were found through pathogenic culture.Results One case of skin and soft tissue HAI occurred in both therapy and non-therapy groups respectively,incidence of HAI were 1.0%and 0.2%respectively,difference was not significant between two groups of patients(P=0.244).Specimens of 30 leech surface and nutrient fluid were collected,and 29(96.7%)of them isolated Alcaligenes faecalis and Providencia rettgeri.Conclusion The risk of skin and soft tissue infection caused by Chinese medicine leech therapy is low,but leech body surface and nutrient fluid often contaminate opportunistic pathogens,it is still important to strengthen control and monitor on infection after therapy.