Etiological and Radiological Profile of Acute Lower Respiratory Infections during the Pre-COVID Period in the Paediatric Ward of the Teaching Hospital of Mali and in the Community Health Centre of Yirimadio in Bamako

Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respiratory infections x-ray aspects in Mali, very few studies have been done to reveal bacteriological and virological evidence of this disease. Materials and methods: It is about a descriptive prospective study carried out from January to December 2018 having involved patients of all ages, coming for medical consultation at the Yirimadio Community-based health center as well as children from 6 months to 15 years old coming at the pediatric department of UHC Hôpital du Mali for a lower respiratory infection. They had all undergone chest X-ray and a PCR. The purpose: of this work is to study etiological and x-ray aspects of acute lower respiratory infections at the Yirimadio Community-based Health Center and at the UHC pediatric department of Hôpital du Mali. Findings: From January to December 2018, we recorded a frequency of 1.19%. The age group 0 - 5 years was the most represented (64.5%) with a sex ratio of 0.97 for women. Cough was the most common clinical sign (98.7%) followed by fever (58.9%). Standard frontal chest X-ray was pathological in 70% of our patients. It was bronchitis in 75.4% of cases, pneumonia (13.5%), and bronchopneumonia (12.3%). PCR positive was in 83.9% of patients. It revealed a co-infection in more than half of the patients (52.5%), bacterial infection (16.1%) and viral infection (15.2%). Pathogens isolated ranked by frequency were Streptococcus pneumoniaa (87.6%) followed by Staphylococcus aureus (24.9%) and human rhinovirus (17%). The most common viral causes were human rhinovirus (17%), followed by influenza A and B virus (7%) and human parainfluenza virus (7%). Conclusion: It stemed from the study that lower respiratory infections were mainly due to Streptococcus pneumonea and human rhinovirus during pre-COVID at the Yirimadio Community-based health center and UHC Hôpital du Mali.

Etiological factors for subphrenic infection after hepatectomy for patients with hepatic malignancy

BACKGROUND: This study was to clarify the high riskfactors for subphrenic infection (SI) after liver resection forpatients with hepatic malignancy.METHODS: Three hundred and sixty-eight patients whohad undergone hepatectomy from January 1985 throughJune 2002 were randomly divided into 2 groups accordingto resection of liver parenchyma, hepatic cirrhosis, primaryliver cancer, intraoperative blood loss, and subphrenicdrainage. The chi-square was used for statistical analysis.RESULTS: Thirteen patients (3.53%) of the 368 patientshad SI. The high-risk factors for SI after hepatectomy wererelated to resection of liver parenchyma and hepatic cirrho-sis ; but the course or stage of primary liver cancer was notrelated to the incidence of SI. Intraoperative blood loss ofover 1500 ml was found to be a significant risk factor forpostoperative SI. Adequate drainage of the subdiaphragmand the raw surface of the liver after operation was essentialto decreasing SI after liver resection.CONCLUSION: Inadequate subphrenic drainage maylargely contribute to SI in patients with hepatic malignancyundergoing hepatectomy apart from other factors. Com-prehensive measures should be taken to prevent the infec-tion after hepatectomy.

Epididymo-Orchitis in Pre-Pubertal Children. Epidemiology, Etiology, Management and Follow-Up Recommendations

Epididymo-Orchitis (EO) is a disease that may affect males in all ages. Neonates and elderly patients may suffer from bacterial infection due to congenital or aging processes affecting the urinary tract. In sexually active post pubertal and young males sexually transmitted organisms may cause EO. EO is also prevalent in pre pubertal healthy boys;however in this group the etiology, the needed imaging modalities and proper management are not clearly defined yet. This manuscript will systematically review the various etiologies causing EO in pre-pubertal boys, discus about the needed proper imaging, and image interpretation, will give treatment and follow-up recommendations.

The many faces of Crohn’s Disease: Latest concepts in etiology

The notion that Crohn’s Disease (CD) occurs as a result of an aberrant reaction to the commensal microbiota in genetically susceptible hosts is widely regarded by physicians and scientists as fact. Yet although it is undisputed that Crohn’s Disease is immune-mediated, an aberrant reaction to one’s own native flora is far from proven. The aim of the current review is to present a summary of the known infectious causes of Crohn’s Disease, whilst highlighting the limitations of using outdated methods to attempt to classify the disease as a single entity. We propose a re-classification of Crohn’s Disease, and suggest that the disease is best conceptualized as a syndrome, an “umbrella-like” term comprising a group of diseases with varying infective etiologies, which clinically, endoscopically and histologically are indistinguishable from CD.

Etiological Factors of Infective Endocarditis in Children Aged 1 Month to 15 Years Hospitalised in the Paediatric Department of CHU Gabriel Touréof Bamako (Mali)

Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.

An epidemiologic study of Helicobacter pylori infection in three areas with high,medium or low incidence of gastric carcinoma

AIMS To study the relation of Helicobacter pylori (Hp) infection rate to the incidence of and mortality from gastric cancer. METHOD Hp infection rate of natural population in three areas was detected by measuring the specific IgG-antibody to Hp using indirect ELISA method. RESULTS Hp positive rate was 59.4%,55.9% and 34.5% in the areas with high,medium and low inci- dence of gastric carcinoma respectively. The differ- ences in incidence among the areas were significant (x^2 =25.029,P<0.05). In persons under 40 years of age,the Hp infection rate was the highest in high inci- dence area of gastric cancer. Hp infection rate was 50% in children under 5 years of age in the high inci- dence area. In the people under 40 years of age,the Hp infection rates showed no difference among the three areas. The average levels of anti-Hp IgG in high, medium and low incidence areas were 2.3±0.49, 2.04±0.47 and 1.84±0.46 respectively. Multivariate regression analysis showed that Hp infection is related to bad hygienic habit,low income,frequent use of an- tibiotics and mental depression. Single factor analysis showed that Hp infection may also be related to raising animals in home. CONCLUSION Gastric cancer is closely related to the incidence of Hp infection.

Ulcerative colitis as a polymicrobial infection characterized by sustained broken mucus barrier

To reduce medication for patients with ulcerative colitis(UC),we need to establish the etiology of UC.The intestinal microbiota of patients with inflammatory bowel disease(IBD)has been shown to differ from that of healthy controls and abundant data indicate that it changes in both composition and localization.Small intestinal bacterial overgrowth is significantly higher in IBD patients compared with controls.Probiotics have been investigated for their capacity to reduce the severity of UC.The luminal surfaces of the gastrointestinal tract are covered by a mucus layer.This normally acts as a barrier that does not allow bacteria to reach the epithelial cells and thus limits the direct contact between the host and the bacteria.The mucus layer in the colon comprises an inner layer that is firmly adherent to the intestinal mucosa,and an outer layer that can be washed off with minimal rinsing.Some bacteria can dissolve the protective inner mucus layer.Defects in renewal and formation of the inner mucus layer allow bacteria to reach the epithelium and have implications for the causes of colitis.In this review,important elements of UC pathology are thought to be the intestinal bacteria,gut mucus,and the mucosa-associated immune system.

Helicobacter pylori: the primary cause of duodenal ulceration or a secondary infection?

INTRODUCTIONIt is generally accepted that Helicobacter pylori ( H.pylori) infection has a role in duodenal ulceration .Eradicaton of H .pylori accelerates healing compared with placebo in the absence of control of gastric secretion and reduces ulcer recurrence .There is increasing evidence ,however ,that is may not be the primary cause of duodenal ulceration ,but that is may be a secondary factor in a nnmber of cases .This possibility is supported by four sets of observations : 1 Geographical distribution:

The Retrospective Study on High Risk Factors of Subphrenic Infection after Hepatectomy

In order to identify the high risk factors that determine subphrenic infection after hepatectomy, 187 liver resections performed during January, 1985 to December, 1990 in Department of Surgery of Tongji Hospital were reviewed. Thirteen patients developed subphrenic infection with the incidence of subphrenic infection being 6. 95%. The results of retrospective study on 187 liver resections demonstrated that the high risk factors related to subphrenic infection after hepatectomy were as follows: (1) The extent of liver resection was associated with subphrenic infection.(2) The incidence of subphrenic infection after liver resection of primary liver cancer patients with hepatic cirrhosis was higher than that of non-cirrhotic patients. (3) Intraoperative estimated blood loss greater than 1500 ml was found to be a significant risk factor in the development of postoperative subphrenic infection.(4) Adequate postoperative drainage of subdiaphragm and the raw surface of the liver was one of critical factors of decreasing subphrenic infection after liver resection.

Heterochronic triple primary malignancies with Epstein-Barr virus infection and tumor protein 53 gene mutation:A case report and review of literature

BACKGROUND The diagnosis and etiology of multiple primary malignant neoplasms(MPMNs)are difficult to establish.Here,we report a case of heterochronic triple primary malignancies with gastric cancer,nasopharyngeal squamous cell cancer,and then rectal cancer.CASE SUMMARY The patient was first diagnosed with gastric cancer at the age of 33 in 2014 and underwent distal gastrectomy and gastrojejunostomy and six cycles of adjuvant chemotherapy.Three years later,he was diagnosed with nasopharyngeal cancer and treated with radical chemoradiotherapy in 2017.Recently,a mass in the middle of the rectum was resected and reported as ulcerative,moderately to poorly differentiated adenocarcinoma.Research on the etiology of MPMNs showed that Epstein-Barr virus(EBV)infection may be the cause of gastric cancer and nasopharyngeal squamous cell cancer since these two primary lesions were positive for transcripts of EBV-encoded ribonucleic acid using an in situ hybridization EBV-encoded ribonucleic acid probe in formalin-fixed,paraffinembedded tissue.The cause of rectal cancer may be due to a somatic mutation of tumor protein 53 gene in exon 8(c.844C>T,p.Arg282Trp)through highthroughput sequencing for the rectal cancer.Appropriate standard therapy for each primary cancer was administered,and the patient has no evidence of cancer disease to date.CONCLUSION To our knowledge,this is the first report on heterochronic triple primary malignancies whose cause may be associated with EBV infection and tumor protein 53 genetic mutations.The etiological research may not only elucidate the cause of MPMN but also has implications in clinical management.

Clinical Analysis of Hospital-acquired Bloodstream Infection in the Elderly

Objective: This study was designed to get epidemiological characteristics, etiology characteristics, prognosis assessment and prognostic factors of hospital-acquired bloodstream infection (HABSI) in the elderly in Chinese PLA General Hospital and aimed at providing a reference for HABSI in the elderly on clinical diagnosis and treatment to improve the prognosis. Methods: The clinical data and pathology data of 210 cases of the elderly patients with HABSI from 2009 to 2012 in geriatric wards were retrospectively analyzed. Compare the clinical assessment effects of APACHE-II score, SAPS-II score and SOFA score to HABSI prognosis in the elderly by plotting the receiver operating characteristic curve. Use univariate and multivariate logistic regression analysis to get prognostic factors of HABSI in the elderly. Results: Univariate analysis of mortality: Day 1 apache -> 18 II score, lung infection, invasive ventilation, chronic hepatic insufficiency, chronic renal insufficiency, substantive organ malignant tumor, deep venipuncture, indwelling gastric tube indwelling ureter, complicated with shock and acquired bloodstream infections in the elderly patients with 7 days survival state association is significant. Day- 1 SOFA score>7, chronic liver dysfunction, chronic renal insufficiency, concurrent shock, hemodialysis and 28-day survival status of patients with acquired bloodstream infection in elderly hospitals were significantly associated. Multivariate unconditioned logistic regression analysis related to death: Day-1APACHE-II score>18, parenchymal malignant tumors, and concurrent shock are independent risk factors for 7-day death in elderly patients with acquired bloodstream infection. Day-1 SOFA score>7, chronic renal insufficiency, and concurrent shock are independent risk factors for 28-day mortality in elderly patients with acquired bloodstream infection. Conclusion: The incidence of acquired bloodstream infections in the elderly was 1.37%. The 7-day and 28-day mortality rates were 8.10% and 22.38%, respectively. Concurrent shock is 26.7%. The 28- day mortality rate of concurrent shock patients was 48.21%. The best outcome score for the 7-day prognosis of elderly patients with acquired bloodstream infection was the Day-1APACHE-II score, followed by the Day-1 SOFA score. The best score for the 28-day prognostic assessment was the Day-1 SOFA score.

陈华教授从“阴虚瘀热”论治小儿反复呼吸道感染经验总结

[目的]总结陈华教授从“阴虚瘀热”论治小儿反复呼吸道感染的经验。[方法]通过随师临证,总结整理病案资料,阐释陈师治疗小儿反复呼吸道感染的临床经验及方药特色,并通过临床验案加以佐证。[结果]陈师认为,小儿反复呼吸道感染病因为风、痰、瘀、虚,病机为肺脾两虚,痰瘀阻络,迁延不愈,瘀热互结,创新性地提出从“阴虚瘀热”辨治小儿反复呼吸道感染,总结出重视风邪,祛风解表;三因制宜,滋阴清瘀;详辨虚实,巧用和法;顾护中焦,健运脾胃的诊治经验。验案为反复呼吸道感染患儿,辨为阴虚感冒,兼痰瘀阻滞证,陈师分期论治,滋阴清瘀治法贯穿疾病治疗的中后期,迁延期养阴退热、化痰祛瘀,恢复期养阴退热、健脾益气,疗效显著。[结论]陈师继承浙派中医儿科特色,从“阴虚瘀热”辨治小儿反复呼吸道感染,疗效显著,对指导临床有较高实用价值。

病毒感染后咳嗽辨治理论探析

在呼吸道病毒感染的高发季节,病毒感染后咳嗽逐渐成为感染者出现的主要症状之一。提高对病毒感染后咳嗽的理解有助于临床工作者进行诊治处理。中医认为,病毒感染后咳嗽以呼吸道病毒感染为始动原因,病机以外邪犯肺、肺失宣降为本,常可损及脾胃肝肾。据此,本文围绕病毒感染后咳嗽的病因病机展开讨论,根据病毒感染后外邪侵袭、机体正气不足,提出清除余邪、扶本益肺为纲与辨证施治相结合的治疗原则,注重后期顾护脏腑功能。

粤东地区2019~2022年儿童呼吸道感染病原学分析

目的分析粤东地区2019~2022年儿童呼吸道感染病原学分布情况,为临床诊疗提供参考依据。方法收集2019年5月~2022年10月期间咽拭子标本(来源均为急性呼吸道感染至汕头市中心医院就诊患儿)3052份,提取病原体核酸,应用逆转录-聚合酶链式反应(RT-PCR)、多重聚合酶链式反应(PCR)技术进行扩增后,进行15种(型)常见呼吸道病原体的筛查,将其分为单纯DNA病毒组、单纯RNA病毒组、单纯细菌组、单纯肺炎支原体组、混合DNA和RNA病毒组、混合病毒和细菌组、混合肺炎支原体和病毒或细菌组。分析儿童呼吸道感染病原学检测结果、各组的性别构成情况,比较各年龄段儿童呼吸道病原体检测阳性情况、月份分布情况。结果呼吸道感染患儿的咽拭子标本3052份,其中阳性2714份,阴性338份,呼吸道感染阳性患儿的性别比例、年龄分布、疾病类型、月份分布和就诊时体温与呼吸道感染阴性患儿有统计学差异(P<0.05)。2714例呼吸道感染阳性患儿中,检出率最高的为巨细胞病毒759例,检出率为28.0%。2714例呼吸道感染患儿中,男性1643例(60.5%),女性1071例(39.5%)。同一病原体的男性发病率明显高于女性。单纯肺炎支原体感染发病率随年龄增长逐渐增加;单纯DNA病毒、单纯RNA病毒、单纯细菌、混合DNA和RNA病毒、混合病毒和细菌发病率随年龄增长逐渐降低。单纯DNA病毒组、单纯RNA病毒组、单纯肺炎支原体组、混合DNA和RNA病毒组、混合肺炎支原体和病毒或细菌组7~9月发病率最高,分别为45.3%、40.7%、46.9%、43.9%、47.4%,单纯细菌组、混合病毒和细菌组4~6月发病率最高,分别为29.3%、29.3%。结论粤东地区儿童急性呼吸道感染以巨细胞病毒为主;发病率男性均比女性高;单纯肺炎支原体感染发病率随年龄增长逐渐增加,单纯DNA病毒、单纯RNA病毒、单纯细菌、混合DNA和RNA病毒、混合病毒和细菌发病率随年龄增长逐渐降低;7~9月呼吸道感染首先应警惕病毒和肺炎支原体感染,如果7~9月呼吸道感染考虑存在细菌感染,应警惕混合病毒或肺炎支原体感染可能。

体外膜氧合期间院内感染流行病学及病原学研究进展

体外膜氧合(ECMO)作为一种体外生命支持技术在医学领域中展现出强大的生命力,为呼吸循环衰竭患者提供强有力的支持,但在ECMO支持过程中,感染、肾衰竭、出血是最常见的并发症,尤其是感染相关并发症的发生发展直接导致患者住院时间的延长及死亡率增加。本文将综述ECMO期间院内感染流行病学及病原学研究进展,针对感染流行病学及病原学进行描述,汇总感染危险因素,为临床抗菌药物使用及临床治疗策略调整提供合理导向。

肉鸡圆圈病毒3型和A型多杀性巴氏杆菌混合感染的检测与分析

为查明福建省龙岩市某鸡场肉鸡消瘦、呼吸困难、病死率升高原因,对发病鸡进行细菌分离鉴定、16S rDNA鉴定、荚膜分型检测、药物敏感试验等分析;以及进行病毒核酸PCR检测、遗传进化分析。结果显示,从病鸡中分离的细菌在血平板上形成圆形、微突起、表面光滑、奶油状的菌落;分离菌16S rDNA核苷酸序列与GenBank中公布的多杀性巴氏杆菌的同源性达到99.9%以上,菌株荚膜为A型;该菌对哌拉西林、头孢氨苄、庆大霉素等药物均表现为高度敏感;从病鸡中检测出圆圈病毒3型(GyV3)VP2基因,与GenBank(登录号MK089248)GyV3同源性最高(99.9%)。结果表明,该鸡场发生圆圈病毒3型和A型多杀性巴氏杆菌引起的混合感染病例。

小鹅瘟病毒、鹅星状病毒Ⅰ型与鸭疫里默氏杆菌混合感染的诊断及病原分析

【目的】2023年4月,河南新乡某地鹅场雏鹅群急性发病,死亡率高达25%,为确定引起该鹅场雏鹅发病的病因,本研究对送检的病死雏鹅进行剖检和实验室诊断。【方法】无菌采集病死雏鹅肝脏、脾脏、肾脏和小肠等组织样品及心血和肝脏外层纤维素性渗出物,通过对心血及肝脏外层纤维素性渗出物样品进行细菌分离培养、革兰染色镜检观察、16S rRNA基因及药物敏感性试验鉴定病鹅感染细菌及感染菌株的药物敏感性情况;通过PCR/RT-PCR方法对其常见雏鹅病毒性传染病病原核酸进行检验,并对阳性病原的主要结构蛋白基因进行测序分析,确定病鹅感染的病毒性病原及其分子流行病学情况。【结果】细菌学试验结果显示,分离菌株在血平板上呈半透明圆形突起、边缘整齐、表面光滑菌落,形态学观察显示,该菌为单个和成对的革兰阴性短杆菌,符合鸭疫里默氏杆菌(Riemerella anatipestifer,RA)的特性。16S rRNA基因扩增测序与BLAST分析进一步证实该菌为RA。药敏试验结果显示,该菌株对头孢曲松和头孢噻肟敏感,对阿莫西林、四环素和多黏菌素B耐药。常见雏鹅病毒性传染病病原核酸PCR/RT-PCR检测发现,该鹅场样品小鹅瘟病毒(Goose parvovirus,GPV)和鹅星状病毒Ⅰ型(genotypeⅠGoose astrovirus,GAstV-1)核酸呈阳性,GAstV-2、禽流感病毒(Avian influenza virus,AIV)和鹅呼肠孤病毒(Goose reovirus,GRV)核酸阴性,将致病毒株分别命名为GPV/HN-2023和GAstV-1/HN-2023。进一步对GPV/HN-2023和GAstV-1/HN-2023的主要结构蛋白基因分析发现,GPV/HN-2023与DY-16株的亲缘关系较近,属于DY-16-like毒株,且VP3蛋白存在2个特有的氨基酸位点突变D248E和V314L;GAstV-1/HN-2023与GAstV-1毒株亲缘关系较近,属于GAstV-1分支,ORF2蛋白存在3个特有的氨基酸位点突变G47R、S207G和A628T。【结论】本研究通过综合诊断方法明确了GPV、GAstV-1与RA混合感染是引起该鹅场雏鹅发病的病因,分析了致病菌RA的耐药性和病毒性致病原GPV和GAstV-1的遗传演化及变异特点,为河南地区雏鹅疫病的科学防控提供理论参考。

慢性肾脏病合并肺部感染的病原菌分布与危险因素分析

目的探讨慢性肾脏病(CKD)合并肺部感染的病原菌分布及危险因素。方法回顾性分析2021年10月—2022年9月东南大学附属中大医院江北院区肾内科收治的310例CKD患者的临床资料,根据是否发生肺部感染分为感染组104例和未感染组206例。统计感染组的病原菌分布情况;采用单因素和多因素Logistic回归分析CKD患者发生肺部感染的危险因素。结果肺部感染组共分离出90株病原菌,主要为革兰氏阴性菌(66.67%),最常见的细菌为肺炎克雷伯菌(23.33%);Logistic分析结果显示,年龄≥65岁、合并胸腔积液、基础疾病数量、侵入性操作、合并低蛋白血症、贫血均为影响CKD患者并发肺部感染的危险因素(P<0.05)。结论CKD合并肺部感染患者的病原菌以革兰氏阴性菌为主,对于存在年龄≥65岁、合并基础疾病数量越多、合并胸腔积液、低蛋白血症,贫血及有侵入性操作等危险因素的CKD患者需要提高重视,可采取针对性的措施预防肺部感染发生。

体外膜氧合期间院内感染的危险因素分析及病原体分布研究

目的 针对体外膜氧合(ECMO)支持期间发生院内感染(NIs)患者的危险因素进行分析并总结病原体分布情况。方法 选取2018年6月至2023年12月新疆医科大学第一附属医院重症医学中心收治的需ECMO支持患者为研究对象,根据病原学研究回示是否诊断NIs分为感染组和非感染组,应用单因素和多因素Logistic回归分析ECMO支持期间发生NIs的危险因素,并汇总分析病原体分布。结果 共68例ECMO支持患者纳入本例研究,平均年龄为(55±13.21)岁,男性53例(77.94%),感染组40例,非感染组28例;39例行静脉-静脉模式,19例行静脉-动脉模式,10例行静脉-动脉-静脉模式;40例(58.82%)患者发生51例次NIs,发病率75.00%,发病密度71.56‰(/1 000 ECMO d),感染部位以下呼吸道感染(45例次,88.24%)为主;检出病原体以革兰阴性菌为主(38株,74.51%),多药耐药菌株17株占33.33%;多因素Logistic回归分析显示,ECMO支持前血乳酸(OR=1.337,95%CI:1.023~1.748,P=0.033)、ECMO支持期间肌酐值(OR=1.019,95%CI:1.001~1.038,P=0.043)及ECMO时长总计(OR=1.524,95%CI:1.022~2.272,P=0.039)是发生NIs的独立危险因素。结论 ECMO支持期间NIs发病率较高,ECMO支持前血乳酸水平、ECMO支持期间肌酐值及ECMO时长总计是其危险因素;针对ECMO支持期间感染高发趋势,应采取积极预防感染措施,强化医护理论培训,降低感染率及死亡率。

径向超声引导支气管肺泡灌洗在肺部感染病原学诊断中的临床应用价值

目的 探讨径向超声引导支气管肺泡灌洗在肺部感染病原学诊断中的临床应用价值。方法 选取2020年8月至2022年8月我科收治的78例肺部感染患者(社区获得性肺炎43例,院内获得性肺炎35例)为研究对象,随机将其分为径向超声引导支气管肺泡灌洗组(径向超声组,40例)及常规支气管肺泡灌洗组(常规组,38例)。比较两组的肺泡灌洗液回收率、病原学检测阳性率、病原学阳性诊断率及临床疗效。结果 径向超声组与常规组的细菌检测阳性率、真菌检测阳性率比较,差异无统计学意义(P>0.05)。径向超声组的病原学阳性诊断率高于常规组(P<0.05)。根据病原学结果调整抗感染治疗方案后,径向超声组的治疗有效率高于常规组(P<0.05)。结论 径向超声引导支气管肺泡灌洗在肺部感染中有较高的病原学阳性诊断率,可为正确、合理的抗感染治疗方案选择提供重要的临床依据。