摘要
目的探讨老年患者菌血症病原菌分布特征与血培养阳性前住院天数、基础疾病、合并其他医院感染的相关性。方法对1999年7月~2002年6月全国医院感染监控网报告资料中经血培养证实的394例次老年患者医院菌血症进行统计分析。结果胃肠道、呼吸系统和肝胆胰疾病以及糖尿病病人血培养阳性前平均住院天数较短,为(11.48±2.85)^(16.98±3.12)d;呼吸系统肿瘤、脑血管疾病的病人血培养阳性前平均住院天数较长,为(53.70±4.14)和(48.46±2.90)d;发生菌血症前的平均住院天数细菌为(24.65±1.82)d,真菌为(35.13±2.9)d,二者相比差异有高度显著性(t=26.87, P<0.01);胃肠道恶性肿瘤、血液造血系统恶性肿瘤、糖尿病、肝胆胰疾病、泌尿系统疾病的患者,菌血症的病原菌分布以革兰阴性菌为多,达52.63%~73.08%;基础疾病为呼吸系统疾病及恶性肿瘤、脑血管疾病、各种损伤者,菌血症的病原菌以革兰阳性菌为多,达54.55%~ 60.00%。394例次老年患者医院内菌血症,有192例次(48.73%)菌血症合并其他医院感染,93.65%(369例次)为原发性血液感染,6.35%(25例次)为继发性血液感染。结论病原菌的分布与基础疾病、血培养阳性前平均住院天数有关;菌血症合并其他医院感染的人数较多,而继发性血液感染率低,提示必须提高血培养送检率。
Objective: To evaluate the distribution of pathogens causing nosocomial bacteremia in senile patients and the relation with the elementary diseases, the average hospitalization days before the positive blood culture and other nosocomial infection. Methods: Three hundred and ninety-four cases of bacteremia reported in the National Nosocomial Infection Surveillance Network from July 1999 to June 2002 were analyzed. Results: The average hospitalization days before the positive blood culture in patients with diseases of gastrointestinal tract, respiratory system and liver, biliary tract pancreas and diabetes mellitus was (11.48±2.85)^(16.98±3.12) days; the average hospitalization days before the blood culture in patients with tumor in respiratory system, blood vessel of brain was (53.70±4.14) and (48.46±2.90) days. Among patients with malignant tumor in gastrointestinal tract and blood system, diabetes mellitus, diseases of liver biliary tract, pancreas and urogenital system, the main pathogens causing bacteremia were Gram-negative bacteria (52.63%~73.08%); among patients with diseases of respiratory system and malignant tumor, blood vessel of brain and all kinds of trauma, the main pathogens were Gram-positive bacteria (54.55%~60.00%). 192 of 394 (48.73%) cases of senile bacteremia developed other nosocomial infection, 93.65% (369 cases) were primary blood infection; 6.35% (25 cases) were secondary infection. Conclusions: The distribution of bacteremia is related with elementary diseases, the average hospitalization days before positive blood culture; more people developed the other nosocomial infection, and secondary blood infection is low, more samples should be detected.
出处
《中国现代医学杂志》
CAS
CSCD
2004年第17期130-133,共4页
China Journal of Modern Medicine
关键词
老年人
医院内菌血症
病原菌分布
基础疾病
平均住院天数
senile patients
nosocomial bacteremia
distribution of pathogens
elementary diseases
average hospitalization days
