紫癜性肾炎患儿医院感染病原学特点及危险因素分析

Etiological characteristics and risk factors of nosocomial infection in children with Henoch Schonlein purpura nephritis

目的 :分析紫癜性肾炎(HSPN)患儿医院感染病原学特点及危险因素,为HSPN医院感染的预防及早期诊治提供依据。方法 :回顾性分析我院于2013年1月～2017年9月期间收治的212例紫癜性肾炎患儿的临床资料,调查患儿医院感染发生情况,采用单因素分析和Logistic回归分析的方法对医院感染的影响因素进行统计学分析。结果 :本研究212例患儿中有45例患儿发生医院感染,发生率为23.11%,感染常见部位为呼吸道感染24例(53.33%)、胃肠道感染9例(20.0%%)、泌尿道感染8例(17.78%);常见病原菌为肺炎克雷伯菌18株(36.73%)、大肠埃希菌13株(26.53%)、流感嗜血杆菌10株(20.41%);单因素分析显示,感染组与未感染组患儿比较在年龄、血浆白蛋白、激素使用及住院时间方面差异存在统计学意义;Logistic回归分析,结果提示血浆白蛋白及住院时间为患儿医院感染的独立危险因素。结论 :紫癜性肾炎患儿医院感染以呼吸道及消化道感染为主,白蛋白水平低及住院时间长是患儿发生医院感染的独立危险因素。

Objective To analyze the etiology and risk factors of nosocomial infection in children with Henoch Schonlein purpura nephritis(HSPN),and to provide evidence for the prevention and early diagnosis and treatment of HSPN with nosocomial infection.Methods 212 cases of children with Henoch Schonlein purpura nephritis of our hospital from September 2013-January2017,the incidence of nosocomial infection in children with the HSPN were investigated,using the method of single factor analysis and Logistic regression analysis for statistical analysis on the influencing factors of nosocomial infection.Results In this study os212 cases,45 cases with nosocomial infection,the incidence rate was 23.11%,the common infection sites were respiratory tract infection in 24 cases(53.33%),9 cases of gastrointestinal tract infection(20.0%%),8 cases of urinary tract infection(17.78%);the common pathogenic bacteria of 18 strains of Klebsiella pneumonia(36.73%)and 13 strains of Escherichia coli(26.53%),10 strains of Haemophilus influenzae(20.41%);single factor analysis showed that the infection group and non infection group were compared with age,serum albumin,hormone use and hospitalization time has statistically significant difference;Logistic regression analysis results indicated that plasma albumin,and hospitalization time were independent risk factors of nosocomial infection.Conclusion Nosocomial infection in children with Henoch Schonlein purpura nephritis is mainly caused by respiratory tract and digestive tract infection.Low albumin level and long hospitalization time are independent risk factors for nosocomial infection.