ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2022, Vol. 31 ›› Issue (6): 508-513.DOI: 10.3969/j.issn.1006-298X.2022.06.002

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肾脏疾病并发医院感染患者的临床特征及预后

  

  • 出版日期:2022-12-28 发布日期:2023-01-04

Clinical characteristics and prognosis of patients with nosocomial infection in renal ward

  • Online:2022-12-28 Published:2023-01-04

摘要: 目的:探究发生医院感染的肾脏疾病患者的临床特征、病原学特点及预后影响因素。
方法:回顾性分析2011年12月至2021年12月国家肾脏疾病临床医学研究中心收治的肾脏疾病合并医院感染的患者,分析其临床资料、病理诊断及预后不良的危险因素。
结果:152例合并院内感染的患者中以肺部感染(51例,3355%)最常见。84例患者培养出病原菌123株,多重耐药菌占比4065%。病原菌以大肠埃希菌最常见(1545%),其次是金黄色葡萄球菌(1057%)。17例(1118%)医院内感染患者预后不良,入院时高中性粒细胞/淋巴细胞比值(NLR)、低CD4+淋巴细胞计数、感染多重耐药菌是患者预后不良的独立危险因素。联合入院时NLR和感染时C反应蛋白对院内并发感染患者预后不良具有预测价值(AUC=0715,P<0001)。
结论:对于入院时高NLR和医院内多重耐药菌感染的肾脏病患者应早期识别,以降低不良结局风险。


关键词: 医院感染, 中性粒细胞/淋巴细胞比值, 病原菌

Abstract: Objective:To investigate the clinical characteristics, pathogenetic features and prognostic factors of patients with renal disease who developed hospitalacquired infections.
Methodology:Patients with renal diseases combined with hospitalacquired infections admitted to the National Center for Clinical Medical Research in Kidney Diseases from December 2011 to December 2021 were retrospectively analyzed for their clinical data, pathological diagnosis and risk factors for poor prognosis.
Results:Among 152 patients with combined nosocomial infections, pulmonary infections (51 cases, 3355%) were the most prevalent. In 84 individuals, 123 pathogenic strains were cultured, and 4065% of those strains were multidrug resistant bacteria. The most prevalent pathogen was Escherichia coli (1545%), which was followed by staphylococcus aureus (1057%). High neutrophiltolymphocyte ratio (NLR), low CD4+lymphocyte count at the time of admission , and infection with multidrug resistant organisms were independent risk factors for poor prognosis in 17 patients (1118%) with nosocomial infections. In patients with nosocomial infections, the combination of NLR upon admission and CRP at the time of infection had prognostic value for a poor prognosis (AUC=0715, P<0001).
Conclusion:Patients with kidney diseases and hospitalacquired infection presented with high NLR and multidrug resistant bacteria infection should be identified early to reduce the risk of poor outcome.


Key words: nosocomial infection, neutrophil-to-lymphocyte ratio, pathogenic bacteria