Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P. R. China.
Nutr Clin Pract. 2020 Oct;35(5):903-910. doi: 10.1002/ncp.10483. Epub 2020 Mar 13.
Intestinal failure (IF) and its management are associated with an increased likelihood of infectious complications. This study aimed to evaluate the prevalence and potential risk factors for nosocomial infections (NIs) in hospitalized adult patients with IF.
In total, 259 eligible patients with IF admitted to a single clinical nutrition center in a tertiary referral hospital from January 1, 2012, to January 1, 2019, were retrospectively identified. NIs were defined according to the 2008 Centers for Disease Control and Prevention criteria. Univariate and multivariate analyses were performed to identify independent risk factors for NIs.
The mean age of the study population was 47.0 ± 17.7 years, and 158 (61.0%) were men. The mean body mass index was 16.2 ± 2.9 kg/m , and 219 (84.6%) were diagnosed with malnutrition. The prevalence of NIs was 25.5% (113 NIs in 66 patients). The most common NIs were pneumonia (14.3%), bacteremia of unknown origin (13.5%), catheter-related bloodstream infection (5.0%), lower respiratory tract infection (5.0%), surgical site infection (3.9%), and urinary tract infection (1.9%). Multivariate analysis revealed that decreased serum albumin level (odds ratio [OR], 0.884; 95% CI, 0.883-0.978, P < .05), presence of gallbladder stones or cholestasis (OR, 3.144; 95% CI, 1.044-9.464; P < .05), and prolonged parenteral nutrition (PN) use (OR, 1.072; 95% CI, 1.039-1.105; P < .001) were independent predictors for NIs.
NIs remain prevalent in hospitalized adult patients with IF. Prolonged PN use was one of the most significant predictors for NIs.
肠衰竭（IF）及其治疗与感染并发症的可能性增加有关。本研究旨在评估住院 IF 成年患者医院获得性感染（NIs）的患病率和潜在危险因素。
回顾性分析 2012 年 1 月 1 日至 2019 年 1 月 1 日期间，一家三级转诊医院的单个临床营养中心收治的 259 例符合条件的 IF 成年患者。根据 2008 年疾病控制与预防中心标准定义 NIs。进行单因素和多因素分析，以确定 NIs 的独立危险因素。
研究人群的平均年龄为 47.0±17.7 岁，158 例（61.0%）为男性。平均体重指数为 16.2±2.9kg/m²，219 例（84.6%）诊断为营养不良。NIs 的患病率为 25.5%（66 例患者中有 113 例 NIs）。最常见的 NIs 为肺炎（14.3%）、不明原因菌血症（13.5%）、导管相关血流感染（5.0%）、下呼吸道感染（5.0%）、手术部位感染（3.9%）和尿路感染（1.9%）。多因素分析显示，血清白蛋白水平降低（比值比 [OR]，0.884；95%置信区间，0.883-0.978，P<.05）、存在胆囊结石或胆汁淤积（OR，3.144；95%置信区间，1.044-9.464；P<.05）和延长肠外营养（PN）使用（OR，1.072；95%置信区间，1.039-1.105；P<.001）是 NIs 的独立预测因素。
NIs 在住院 IF 成年患者中仍然普遍存在。延长 PN 使用是 NIs 的最重要预测因素之一。
