摘要
目的 探讨产超广谱β内酰胺酶（ESBLs）肺炎克雷伯菌医院获得性肺炎的临床危险因素。方法 选取2001—07—2004—12武汉走学人民医院收治的肺炎克雷伯菌医院获得性肺炎101例，38例产ESBLs肺炎克雷伯菌医院获得性肺炎作为病例组。63例非产ESBLs肺炎克雷伯菌医院获得性肺炎作为对照组。对产Es—BLs肺炎克雷伯菌肺炎的危险因素进行病例对照研究。结果 ESBLs阳性组对12种抗生素的耐药性远远高于ESBLs阴性组。单因素分析发现住院时间大于20d、入住重症监护病房（ICU）、气管插管或切开、留置导管、机械通气、头孢噻肟的使用是产ESBLs肺炎克雷伯菌引起医院获得性肺炎的主要危险因素。多因素非条件logistic回归分析表明，头孢噻肟的使用是产ESBLs肺炎克雷伯菌医院获得性肺炎的独立危险因素。结论 长程住院、入住ICU等是ESBLs肺炎克雷伯菌医院获得性肺炎发生的危险因素，尤以头孢噻肟的使用是主要危险因素。
Objective To analyze risk factors of nosocomial pneumonias due to ESBL - producing Klebsiella pneumoniae. Methods From July 2001 to December 2004, 38 patients with ESBL - producing K. pneumoniae and 63 patients with non - ESBL - producing K. pneumoniae were enrolled. ESBL - producing strains were detected by confirmed test. Results Hospdal duration, ICU stay, tracheal intubation or tracheotomy, indwelling catheters, mechanical ventilation and use of cefotaxime were found to be risk factors in the acquisition of K. pneumoniae with ESBLs by univariate analysis. Cefotaxi,ne use remained as risk factors by multivariate analysis with logistic regression. Conclusion The reasonable use of cefotaxime is an important measure to control the prevalence of ESBLs - producing strains of Klebsiella pneumoniae.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2006年第3期354-355,共2页
Chinese Journal of Practical Internal Medicine
关键词
肺炎克雷伯菌
超广谱Β内酰胺酶
危险因素
Klebsiella pneumoniae
Extended - spectrum β - lactamases
Risk factor
