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中华实验和临床感染病杂志(电子版) ›› 2018, Vol. 12 ›› Issue (02) : 128 -133. doi: 10.3877/cma.j.issn.1674-1358.2018.02.006

所属专题: 文献

临床论著

洋葱伯克霍尔德菌血流感染危险因素及其同源性
茅国峰1,(), 梁美春1, 陈建东2, 周洁3   
  1. 1. 312000 绍兴市,绍兴市人民医院检验科
    2. 312000 绍兴市,绍兴市人民医院ICU
    3. 312000 绍兴市,绍兴市人民医院感染科
  • 收稿日期:2017-06-22 出版日期:2018-04-15
  • 通信作者: 茅国峰
  • 基金资助:
    浙江省医药卫生研究计划(No. 2016KYB304)

Risk factors and homology of bloodstream infection in Burkholderia cepacia

Guofeng Mao1,(), Meichun Liang1, Jiandong Chen2, Jie Zhou3   

  1. 1. Department of Clinical Laboratory, Shaoxing People’s Hospital, Shaoxing 312000, China
    2. Intensive Care Unit, Shaoxing People’s Hospital, Shaoxing 312000, China
    3. Department of Infectious Diseases, Shaoxing People’s Hospital, Shaoxing 312000, China
  • Received:2017-06-22 Published:2018-04-15
  • Corresponding author: Guofeng Mao
  • About author:
    Corresponding author: Mao Guofeng, Email:
引用本文:

茅国峰, 梁美春, 陈建东, 周洁. 洋葱伯克霍尔德菌血流感染危险因素及其同源性[J/OL]. 中华实验和临床感染病杂志(电子版), 2018, 12(02): 128-133.

Guofeng Mao, Meichun Liang, Jiandong Chen, Jie Zhou. Risk factors and homology of bloodstream infection in Burkholderia cepacia[J/OL]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2018, 12(02): 128-133.

目的

探讨洋葱伯克霍尔德菌血流感染(BSI)的危险因素及其同源性。

方法

收集绍兴市人民医院204年1月至2016年12月血流感染者中分离到的洋葱伯克霍尔德菌,应用脉冲场凝胶电泳(PFGE)揭示菌株间的同源性。同时分析洋葱伯克霍尔德菌BSI者的临床资料,以非洋葱伯克霍尔德菌BSI者作为对照组,探讨洋葱伯克霍尔德菌BSI的危险因素,并以是否存活作为预后判定标准,对洋葱伯克霍尔德菌BSI进行单因素和多因素Logistic回归分析,分析影响预后的相关因素。

结果

32株洋葱伯克霍尔德菌共分为7个克隆株,其中克隆A 15株,克隆B 8株,克隆C 3株,克隆D 2株和克隆E各2株,克隆F和克隆G各1株。32例洋葱伯克霍尔德菌BSI者中,12例死亡,病死率为37.5%。非洋葱伯克霍尔德菌BSI者77例,多因素Logistic回归分析发现年龄、重症监护病房(ICU)住院时间> 2周、APACHE Ⅱ评分和菌株外排泵基因的存在均为洋葱伯克霍尔德菌BSI的独立危险因素(OR = 8.835、6.353、6.679和5.606,P均< 0.05)。

结论

血流感染洋葱伯克霍尔德菌主要在ICU病房流行,存在克隆传播现象。年龄、ICU住院时间大于2周、APACHE Ⅱ评分和菌株外排泵基因的存在患者更易导致洋葱伯克霍尔德菌血流感染。

Objective

To investigate the risk factors and homology of bloodstream infection (BSI) in Burkholderia cepacia.

Methods

The Burkholderia cepacia isolated from patients with bloodstream infection in Shaoxing People’s Hospital from January 2014 to December 2016 were collected and analyzed by pulsed field gel electrophoresis (PFGE). The clinical data of BSI patients with Burkholderia cepacia were analyzed, patients with non-Burkholderia cepacia blood BSI were collected as control group. The risk factors of BSI in Burkholderia cepacia were investigated, and survival or not was taken as a prognostic criterion for Burkholderia cepacia of strain BSI, Logistic regression analysis of single factor and multi-factors were carried out, and the influencing factors of survival were analyzed.

Results

Total of 32 strains of Burkholderia cepacia were divided into 7 clones, named as cloned A (15 strains), cloned B (8 strains), cloned C (3 strains), cloned D and cloned E (each of the 2 strains), cloned F and cloned G (each of the 1 strains). Twelve patients died of BSI of Burkholderia cepacia, the mortality rate was 37.5%. There were 77 cases of non-Burkholderia cepacia in patients with BSI, multiple Logistic regression analysis showed that age, hospitalization of ICU longer than two weeks, APACHE Ⅱ score and strain of efflux pump gene were all independent risk factors for BSI of Burkholderia cepacia (OR = 8.835, 6.353, 6.679 and 5.606, all P < 0.05).

Conclusions

The infection of Burkholderia cepacia in ICU ward was popular. Age, hospitalization period of ICU longer than two weeks, APACHE Ⅱ score and the presence of efflux pump gene were more likely to cause BSI Burkholderia cepacia in patients.

图1 32株洋葱伯克霍尔德菌PFGE图
表1 两组患者血流感染的危险因素
表2 洋葱伯克霍尔德菌BSI预后的单因素分析
表3 洋葱伯克霍尔德菌BSI预后的多因素Logistic回归分析
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