127例金黄色葡萄球菌血流感染临床流行病学分析
| 作者: |
1,2闫震,
3康海全,
3赵树龙,
3朱迎星,
3刘乐,
1,3马萍
1 徐州医科大学医学技术学院，江苏 徐州 221004 2 徐州医科大学附属医院输血科，江苏 徐州 221002 3 徐州医科大学附属医院检验科，江苏 徐州 221002 |
| 通讯: |
马萍
Email: pingm62@aliyun.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.10.020 |
| 基金: | 江苏省六大人才高峰项目(WSN-091)；徐州市科技计划项目(KC19160)。 |
摘要
目的：探究金黄色葡萄球菌(以下简称金葡菌)血流感染的临床特征，分析预后不良的危险因素，为金葡菌血流感染的诊治提供依据。方法：回顾分析2018年9月至2020年8月徐州医科大学附属医院127例金葡菌血流感染病例，收集临床特征和实验室数据，运用单因素和多因素logistic回归，分析转归相关的危险因素。结果：Logistic多因素回归分析显示预后不良的独立危险因素为脑卒中、重症监护室(intensive care unit，ICU)、中心静脉插管、降钙素原(procalcitonin，PCT)升高(OR值为12.123、4.906、3.315、15.879)。对金葡菌进行耐甲氧西林金葡菌(methicillin-resistant Staphylococcus aureus，MRSA)和甲氧西林敏感金葡菌(methicillin-sensitive Staphylococcus aureus，MSSA)分组，通过比值比分析，中心静脉插管、ICU、PCT升高3个独立危险因素存在时感染MRSA的可能性较大(OR值为4.048、4.141、3.231，且95%CI不包括1)，差异有统计学意义。结论：脑卒中、中心静脉插管、ICU、PCT升高在金葡菌血流感染患者预后不良中起重要作用，控制好MRSA感染有利于改善患者的预后。
关键词：
金黄色葡萄球菌；血流感染；耐甲氧西林金黄色葡萄球菌；危险因素
Clinical epidemiological analysis of 127 cases of Staphylococcus aureus bloodstream infection
CorrespondingAuthor: MA Ping Email: pingm62@aliyun.com
DOI: 10.3978/j.issn.2095-6959.2021.10.020
Foundation: This work was supported by Six Talent Peak Projects of Jiangsu Province (WSN-091) Xuzhou Science and Technology Project (KC19160), China.
Abstract
Objective: To explore the clinical characteristics of Staphylococcus aureus (S. aureus) bloodstream infection, analyze the risk factors of poor prognosis, and provide basis for the diagnosis and treatment of S. aureus bloodstream infection. Methods: A total of 127 cases of S. aureus bloodstream infection admitted to Affiliated Hospital of Xuzhou Medical University from September 2018 to August 2020 were retrospectively analyzed. Clinical characteristics and laboratory data were collected, and risk factors were identified by univariate and multivariate logistic regression analysis. Results: Logistic multivariate regression analysis showed that the independent risk factors for poor prognosis were stroke, ICU, central venous catheters, and increased PCT (OR values were 12.123, 4.906, 3.315, 15.879). MRSA and MSSA were grouped for S. aureus. Odds ratio analysis showed that the possibility of MRSA infection was higher when the three independent risk factors of central venous catheters, ICU and elevated PCT were found (OR value was 4.048, 4.141, and 3.231, and the 95%CI didn’t include the 1), and the difference was statistically significant. Conclusion: Stroke, central venous catheters, ICU and increased PCT play an important role in the poor prognosis of patients with bloodstream infection with S. aureus, and good control of MRSA infection is beneficial to treatment efficacy improvement.
Keywords：
Staphylococcus aureus; bloodstream infection; methicillin-resistant Staphylococcus aureus; risk factors