海南南部某医院10年间类鼻疽伯克霍尔德菌感染调查及疗效分析

Analysis of Burkholderia pseudomallei infections and treatment efficacy in a hospital in southern Hainan during the past ten years

目的分析海南南部地区2012—2022年类鼻疽感染流行病学特征及治疗情况,为类鼻疽伯克霍尔德菌感染的治疗提供科学依据。方法收集2012—2022年治疗的171例类鼻疽确诊病例资料进行统计分析。把171例患者分为血流感染组(104例)和非血流感染组(67例),对比两组患者的药敏试验结果、治疗有效率、死亡率,并分析手术治疗有效率及调整用药后的有效率。结果秋季感染病例最多,占42.11%。病例分布在6个市县的29个镇,三亚市最多,占69.01%。临床类型以血流感染为主,占60.82%,其次是肺部感染(19.88%),化脓性感染病例占19.30%。血流感染组与非血流感染组常用抗菌药物敏感率差异无统计学意义(P>0.05)。血流感染组死亡率(25.0%)高于非血流感染组死亡率(1.49%)。血流感染组治疗总有效率(65.39%)低于非血流感染组总有效率(88.06%,χ^(2)=44.46,P<0.01)。有51例进行手术治疗,有效率为68.63%。联合用药治疗的有效率(86.05%)高于单一用药治疗的有效率(56.82%,χ^(2)=0.21,P>0.05)。结论海南南部地区类鼻疽感染呈上升趋势,所致感染类型为多样性。联合用药治愈率高。

This study was aimed at analyzing the epidemiological characteristics and treatment of melioidosis infections in southern Hainan from 2012 to 2022,to provide a scientific basis for the treatment of Burkholderia pseudomallei infection.A total of 171 patients were divided into a bloodstream infection group(104 cases)and non blood stream infection group(67 cases).The drug sensitivity test results,treatment effectiveness,mortality,surgical treatment effectiveness,and adjusted medication effectiveness between groups were statistically analyzed.The highest incidence rate of infection,42.11%,was observed in autumn and was distributed in 29 towns in six cities and counties.The region with the highest incidence was Sanya(69.01%).The main clinical manifestations were bloodstream infection(60.82%)and pulmonary infection(19.88%).Abscess cases increased significantly,accounting for 19.30%.The sensitivity rate of commonly used antibacterial drugs exceeded 90.0%and did not significantly differ between the blood flow infection group and non blood flow infection group(χ^(2)=3.42,P>0.05).The mortality rate in the blood flow infection group was 25.0%,a value significantly higher than that in the non blood flow infection group(1.49%).The total efficacy rate in the blood flow infection group was 65.39%,a value significantly lower than that in the non blood flow infection group(88.06%,χ^(2)=44.46,P<0.01).A total of 51 cases underwent surgery,and the efficacy rate was 68.63%.The efficacy rate of combined drug therapy was 86.05%,a value significantly higher than that of single drug therapy(56.82%).Melioidosis infections in southern Hainan are increasing.The types of infection are diverse,and the cure rate with combined drug treatment is high.