摘要
目的回顾分析本院收治的新型冠状病毒肺炎(COVID-19)合并细菌及真菌感染患者的炎症指标、感染菌株分布及药敏情况,为COVID-19合并细菌感染患者的诊治提供依据。方法收集2020年1月23日至4月22日期间本院收治的、进行细菌及真菌培养的125例COVID-19患者病例资料,并对其炎症指标(WBC、CRP、PCT)及对培养出的阳性菌株和药敏结果,结合临床治疗的用药情况进行分析。结果125例患者各类标本中共有19例细菌或真菌培养阳性,其中细菌阳性12例(63.2%),念珠菌感染阳性7例(36.8%)。培养阳性组与培养阴性组在平均年龄、是否有基础病和COVID-19临床分型三方面差异均有统计学意义(P<0.01);培养阳性组的炎症指标WBC、CRP、PCT均有不同程度的升高,与培养阴性组相比差异也有统计学意义(P<0.01)。使用莫西沙星、头孢哌酮/舒巴坦治疗细菌及真菌感染,疗效显著。结论COVID-19患者有合并感染细菌及真菌的风险,可发生败血症、呼吸道感染、泌尿生殖道感染;WBC、CRP、PCT可作为COVID-19患者合并细菌及真菌感染的鉴别指标;及时进行细菌及真菌培养和药敏试验,有利于COVID-19合并细菌及真菌感染患者的诊治。
Objective To provide support for the diagnosis and treatment of COVID-19 patientscomplicated with bacterial infectionin our hospital by retrospectively analyze inflammatory indicators,distribution ofinfection strains and antibiotic susceptibility test.Methods The data on 125 patients with COVID-19 who had been treated and received bacterial and fungal cultures in our hospital from January 23,2020 to April 22,2020.PCT,WBC,and CRP,positive strains and antimicrobial susceptibility results were analyzed in combination with the clinical treatment.Results Of 125 patients,19 were positive for bacterial or fungal culture;bacterial infection occurred in 12(63.2%)patients and candida infection occurred in 7(36.8%)patients.There were significant differences in mean age,presence of underlying diseases,and clinical typing of COVID-19 pneumonia between culture-positive and-negative groups(P<0.01);The inflammatory indicators PCT,WBC and CRP were increased at different levels in culture-positive patients,and differed significantly between culture-negative and-positive patients(P<0.01).Moxifloxacin and cefoperazone-sulbactam showed significant efficacy in the treatment of bacterial or fungal infection.Conclusions COVID-19 patients are at risk for nosocomial bacterial or fungal infection,and develop sepsis,respiratory and genitourinary infections.WBC,PCT and CRP can be used as the differential indicators of bacterial or fungal infection in COVID-19 pneumonia patients.Timely bacterial or fungal culture and antibiotic susceptibility test are beneficial to the diagnosis and treatment of COVID-19 pneumonia with bacterial or fungal infection.
作者
赖展翔
范颖敏
区静怡
陈美君
陈星
石亚玲
李凌华
陈万山
LAI Zhanxiang;FAN Yingmin;OU Jingyi;CHEN Meijun;CHEN Xing;SHI Yaling;LI Linghua;CHEN Wanshan(Department of Clinical Laboratory,Guangzhou Eighth People's Hospital,Guangzhou 510060,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2021年第1期16-19,共4页
The Journal of Practical Medicine
基金
广州市高水平临床重点专科传染病专科(编号:2019-2021)。
