侵袭性肺炎链球菌感染调查及危险因素分析

摘要

Objective To investigate the prevalence and risk factors of infection caused by invasive Streptococcus pneumonia (Spn),provide reference for prevention and control of invasive Spn infection.Methods Review the clinical data of invasive Spn infection in our hospital.A case-control study was carried out to identify the risk factors through single factor analysis and multi-factor logistic regression.Results Among forty-three patients of invasive Spn infection,bloodstream infection accounted for 86.0 ％ and other infections accounted for 14.0 ％,including central nervous system infection,abdomen and thorax infections.The risk factors of invasive Spn infection were age ＜ 5 years old (OR =3.67),patients presenting with chronic liver disease (cirrhosis,alcohol abuse) (OR =12.73),hospitalization within a year (OR=4.69) and autoimmune disease (OR=5.43).The independent risk factors of invasive Spn infection were age ＜5 years old,patients presenting with chronic liver disease (cirrhosis,alcohol abuse) and autoimmune disease.Conclusion The high-risk groups infected invasive Spn include children ＜5 years of age and patients presenting with chronic liver disease or autoimmune disease.It's critical to vaccinate high-risk groups and improve the patient's immune system function so as to prevent and control invasive Spn infection.%目的 了解侵袭性肺炎链球菌(Streptococcus pneumonia,Spn)感染现状及其危险因素,为有效预防和控制侵袭性Spn感染提供参考资料.方法 回顾性调查我院侵袭性Spn感染病例资料,采用病例对照研究方法,对侵袭性Spn感染的相关因素进行单因素分析和多因素非条件logistic回归分析,确定危险因素.结果 43例侵袭性Spn感染患者,血液感染占86.0％,中枢神经系统及胸、腹腔感染占14.0％;单因素分析显示侵袭性Spn感染的危险因素包括年龄＜5岁(OR=3.67)、肝硬化或酗酒引起的慢性肝病(OR=12.73)、近1年有住院史(OR=4.69)和自身免疫性疾病(OR=5.43);多因素非条件logistic回归分析进一步显示侵袭性Spn感染的独立危险因素为年龄＜5岁、肝硬化和酗酒引起的慢性肝病以及自身免疫性疾病.结论 侵袭性肺炎链球菌感染高危人群是年龄＜5岁的儿童、慢性肝病及自身免疫性疾病患者,针对高危人群尽早采取疫苗接种措施,积极改善机体免疫功能状态是有效预防和控制侵袭性肺炎链球菌感染的关键.