摘要
目的探讨2型糖尿病(T2DM)患者糖化血红蛋白(HbA1c)水平与患者医院感染的相关性。方法选取128例T2MD患者为研究对象,采用Cox回归分析对T2DM患者感染因素进行分析,并根据患者HbAlc水平将患者分为A组(HbA1c≤6.5%)以及B组(HbA1c>6.5%),对比分析两组患者临床感染情况、病死率、病原菌种类以及抗菌治疗效果的差异。结果 128例患者中发生医院感染45例,感染率为35.15%,经单因素分析,引起糖尿病患者医院感染的因数包括年龄、住院时间、抗菌药物种类、基础疾病、侵入性治疗等;A组患者医院感染率为22.58%,与B组43.94%比较明显降低,差异有统计学意义(P<0.05);两组患者感染部位主要为下呼吸道、尿路及皮肤;两组患者病原菌种类均以为金黄色葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌为主,A组患者病原菌分别占47.06%、23.53%、11.76%,B组分别占26.32%、15.79%、26.32%;抗菌药物治疗时间A组患者为(10.23±2.45)d、B组为(14.35±3.24)d显著长于A组,差异有统计学意义(P<0.05)。结论年龄、住院时间、抗菌药物种类、基础疾病、侵入性治疗项目是导致T2MD患者医院感染的主要因素,而HbA1c水平控制较差的患者更容易出现医院感染,且抗菌治疗时间较长。
OBJECTIVE To investigate correlation between patients with type 2 diabetes （T2DM） glycosylated hemoglobin （HbA1c） level and in-hospital infection. METHODS A total of 128 cases of T2MD patients were selected for the study. The infectious factors of T2DM patients were analyzed with Cox regression. Patients were divided into group A （HbA1c ≤ 6.5%） and group B （HbA1c〉 6.5%） according to HbA1c level. The difference of clinical infection situation, mortality, pathogens and antimicrobial treatment effect were compared. RESULTS There were total of 45 cases of nosocomial infections among 128 cases, accounting for 35.15 %. Age, duration of hospitalization, antibiotic drug, underlying diseases, invasive treatment programs were factors of patients with diabetes causing nosocomial infections after the single factor analysis. The infection rate of group A （22.58%） was lower than that in group B （43.94%） , and the difference had statistical significance（P〈0.05）. The mainly infection sites were lower respiratory tract urinary tract and skin. The main pathogens in both groups were Staph- ylococcusaureus, Pseudornonas aeruginosa and Klebsiella pneumoniae, accounting for 47. 06%, 23. 53% and 11.76% in group A and 26.32%, 15.79% and 26.32% in group B. The antimierobial treatment time（ 14.35± 3.24 d vs. 10.23 ± 2.45 d） of group B was significantly longer than that in group A, and the difference had statistical significance （P〈0.05）. CONCLUSIONS Age, length of stay, type of antimicrobial drugs, underlying diseases and invasive treatment programs are the major factors of patients with T2MD getting nosocomial infections. Patients with poorly controlled HbA1c levels were more prone to get nosocomial infections and with a longer time of antimicrobial therapy.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第11期2729-2731,共3页
Chinese Journal of Nosocomiology
基金
卫生部中日友好医院重点基金资助项目(2010-ZD-06)
关键词
糖尿病
糖化血红蛋白
医院感染
Diabetes
Glycosylated hemoglobin
Nosocomial infections
