实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (2): 257-260.doi: 10.3969/j.issn.1672-5069.2026.02.024

• 肝硬化 • 上一篇    下一篇

乙型肝炎肝硬化患者多重耐药菌感染率、病原菌分布和影响因素分析*

孙恒亮, 蒋海薇, 张力   

  1. 226600 江苏省南通市 海安市中医院检验科(孙恒亮);海安市疾病预防控制中心微生物检验科(蒋海薇);南京医科大学附属儿童医院检验科(张力)
  • 收稿日期:2025-03-21 出版日期:2026-03-10 发布日期:2026-03-13
  • 通讯作者: 蒋海薇,E-mail:13912400511@163.com
  • 作者简介:孙恒亮,男,44岁,大学本科,副主任技师。E-mail:13912400511@163.com
  • 基金资助:
    *江苏省南通市科技局科研计划指导性项目(编号:WSZ2023125)

Prevalence, pathogens distribution and risk factors of multi-drug resistant bacteria infection in patients with hepatitis B-induced liver cirrhosis

Sun Hengliang, Jiang Haiwei, Zhang Li   

  1. Clinical Laboratory, Traditional Chinese Medicine Hospital, Hai’an 226600, Nantong, Jiangsu Province, China
  • Received:2025-03-21 Online:2026-03-10 Published:2026-03-13

摘要: 目的 调查乙型肝炎肝硬化(LC)患者多重耐药菌感染率、病原菌分布和影响因素。方法 2021年1月~2024年12月我院收治的乙型肝炎导致的LC患者1085例,收集临床资料,统计分析细菌感染发生率、病原菌分布和多重耐药菌感染情况。应用Logistic回归分析影响多重耐药菌感染的因素。结果 本组1085例LC患者细菌感染发生率为28.9%,在314感染者中共分离出病原菌381株,其中革兰阴性菌233株(61.2%),革兰阳性菌148株(38.8%);大肠埃希菌对环丙沙星耐药率为74.2%,铜绿假单胞菌对环丙沙星耐药率为74.2%,葡萄球菌对氨苄西林耐药率为87.8%,屎肠球菌对红霉素耐药率为71.1%;在314例并发细菌感染的LC患者中发生多重耐药菌感染182例(58.0%);发生多重耐药菌感染患者住院时间长、Child-Pugh C级、90 d内应用过抗生素、侵入性操作、糖尿病和消化道出血占比显著高于未发生多重耐药菌感染患者(P<0.05),这些因素均系发生多重耐药菌感染的独立危险因素。结论 乙型肝炎导致的LC患者发生多重耐药菌感染风险较高,临床应针对危险因素积极预防和及时诊治,以改善预后。

关键词: 肝硬化, 病原菌分布, 多重耐药菌感染, 影响因素

Abstract: Objective The aim of this study was to investigate prevalence, pathogens distribution and risk factors of multi-drug resistant (MDR) bacteria infection in patients with hepatitis B-induced liver cirrhosis (LC). Methods A total of 1085 consecutive patients with hepatitis B-induced LC were admitted to our hospital between January 2021 and December 2024, clinical materials were collected, and incidence of bacterial infection, distribution of pathogens and impacting risk factors were statistically analyzed. Results Of 1085 patients with LC, incidence of bacterial infection was 28.9% and 381 strains of pathogens, including 233 (61.2%) strains of Gram-negative bacteria and 148 (38.8%) strains of Gram-positive bacteria, were separated from the 314 cases; resistance rate of Escherichia Coli to ciprofloxacin was 74.2%, resistance rate of Pseudomonas Aeruginosa to ciprofloxacin was 74.2%, resistance rate of Staphylococcus to ampicillin was 87.8%, and resistance rate of Enterococcus Faecalis to erythromycin was 71.1%; MDR infection was found in 182 cases(58.0%) out of the 314 patients with bacterial infection, long periods of hospital stay, percentages of Child-Pugh class C, repeatedly antibiotic administration within 90 days, invasive manipulation, concomitant diabetes and complicated gastrointestinal bleeding in patients with MDR infection were significantly higher than in those without, and all these parameters were independent risk factors(P<0.05) for MDR infection. Conclusion Patients with hepatitis B-induced LC have a tendency of bacteria infection, and those with deteriorated liver functions are even more susceptible to MDR infections, which should be carefully managed for prevention and treatment.

Key words: Liver cirrhosis, Pathogen distribution, Multi-drug resistant bacteria infection, Risk factors