【摘要】：目的探討惡性腫瘤合并醫(yī)院獲得性屎腸球菌血流感染患者的臨床特點及其死亡危險因素。方法回顧性收集2012年1月-2015年12月惡性腫瘤合并醫(yī)院獲得性屎腸球菌血流感染93例患者的臨床資料,采用logistic回歸分析死亡危險因素。結(jié)果 93例患者中腫瘤類型為實體腫瘤82例占88.17%;伴有發(fā)熱患者86例占92.47%,伴有寒顫患者56例占60.22%;白細胞計數(shù)和(或)中性粒細胞計數(shù)升高84例占90.32%,C-反應(yīng)蛋白(CRP)升高89例占95.70%;繼發(fā)性血流感染61例占65.59%;藥敏數(shù)據(jù)顯示,對萬古霉素的耐藥率為5.63%,無替考拉寧和利奈唑胺耐藥菌株;30天病死率為26.88%;單因素分析顯示入住ICU、腎功能不全、查爾森合并指數(shù)(CCI)、急性生理慢性健康評分(APACHEⅡ)、繼發(fā)血流感染、發(fā)病前30天內(nèi)行外科手術(shù)、化療、機械通氣、氣管插管/切開和留置尿管與死亡相關(guān)(P0.05);多因素logistic回歸分析顯示僅APACHE II評分與死亡相關(guān)(P0.001)。結(jié)論惡性腫瘤合并醫(yī)院獲得性屎腸球菌血流感染患者的臨床特點主要有發(fā)熱、寒顫、白細胞和(或)中性粒細胞升高、CRP升高;屎腸球菌分離株對萬古霉素、替考拉寧和利奈唑胺均敏感;高APACHEⅡ評分是死亡的獨立危險因素。
[Abstract]:Objective to investigate the clinical features and risk factors of death in patients with malignant tumor complicated with nosocomial enterococcus faecium blood flow infection. Methods the clinical data of 93 patients with malignant tumor complicated with hospital acquired enterococcus faecium blood flow infection from January 2012 to December 2015 were retrospectively collected. The risk factors of death were analyzed by logistic regression. Results of the 93 cases, 82 cases were solid tumors (88.17%), 86 cases with fever (92.47%), 56 cases with shivering (60.22%), 86 cases with fever (92.47%) and 56 cases with shivering (60.22%). Leukocyte count and / or neutrophil count increased in 84 cases (90.32%), C-reactive protein (CRP) increased in 89 cases (95.70%), secondary blood flow infection in 61 cases (65.59%). The drug sensitivity data showed that the resistance rate to vancomycin was 5.63%, no teicoplanin and linazolamine resistant strains were found, the 30-day mortality rate was 26.88%, and the resistance rate to vancomycin was 5.63%. Univariate analysis showed renal insufficiency in ICU, (CCI), acute physiological and chronic health score (APACHE 鈪，

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