Kusaba Ryoko, Yasumasu Keisuke, Konishi Kenichiro, Yamato Yasuhiko, Kikawa Satoko, Okumura Kenji, Maeda Junko, Morinaga Shingo, Matsukura Makoto, Kimura Akihiko
Pediatrics, Kumamoto-Ashikita Medical Center, Kumamoto, JPN.
Pediatrics, Faculty of Life Sciences, Kumamoto University, Kumamoto, JPN.
Cureus. 2023 Mar 15;15(3):e36174. doi: 10.7759/cureus.36174. eCollection 2023 Mar.
At our institution, patients of all ages with extremely severe motor and intellectual disabilities (ESMID) receive comprehensive management similar to intensive care for "extremely ill patients." Some patients with ESMID develop frequent infections that are difficult to manage. The purpose of this study was to identify risk factors for frequent infections in these patients.
Thirty-seven patients with ESMID who were treated for infections at our institution between September 2018 and August 2019 were retrospectively investigated. Frequent infection was defined as three or more episodes of infection and antimicrobial treatment in one year. Infection status and potential risk factors for frequent infections (patient background factors, severity score, hematological parameters, anthropometry index, and parenteral nutritional status) were examined in univariate and multivariate analyses.
Frequent infections occurred in 11 of the 37 patients (29.7%) during the study period, including respiratory and urinary tract infections. Univariate and multivariate analyses suggested hypoalbuminemia (p<0.01) and hypertriglyceridemia (p<0.01) were independent risk factors for frequent infections.
Hypoalbuminemia and hypertriglyceridemia may be risk factors for frequent infections in patients with ESMID.
在我们机构，所有年龄段的极重度运动和智力残疾（ESMID）患者接受类似于对“危重症患者”的重症监护的综合管理。一些 ESMID 患者会频繁发生难以控制的感染。本研究的目的是确定这些患者频繁感染的危险因素。
回顾性调查了 2018 年 9 月至 2019 年 8 月期间在我们机构因感染接受治疗的 37 例 ESMID 患者。频繁感染定义为一年内发生三次或更多次感染并接受抗菌治疗。在单因素和多因素分析中检查了感染状况和频繁感染的潜在危险因素（患者背景因素、严重程度评分、血液学参数、人体测量指数和肠外营养状况）。
在研究期间，37 例患者中有 11 例（29.7%）发生频繁感染，包括呼吸道和泌尿道感染。单因素和多因素分析表明，低白蛋白血症（p<0.01）和高甘油三酯血症（p<0.01）是频繁感染的独立危险因素。
低白蛋白血症和高甘油三酯血症可能是 ESMID 患者频繁感染的危险因素。
