摘要
目的分析重症监护病房(ICU)耐碳青霉烯类肠杆菌科细菌(CRE)感染发生的独立危险因素,为有效防控CRE感染的发生提供科学依据。方法回顾性分析我院ICU 2017年1月~2018年10月收治的肠杆菌科细菌感染患者261例的临床资料,根据是否发生碳青霉烯类抗生素耐药将患者分为碳青霉烯类耐药组(CRE组,n=147例)和碳青霉烯类敏感组(CSE组,n=114例)。单因素分析两组间的差异,Logistic回归分析ICU中CRE感染发生的独立危险因素。结果单因素分析显示,两组患者的性别、住院时间、住ICU时间、预后、细菌种类、联用抗生素、混合感染、人工气道、机械通气、连续肾脏替代治疗、输血、免疫抑制状态、昏迷、急性生理和慢性健康评分比较差异有统计学意义(P<0.05)。Logistic回归分析显示,男性(OR=2.273,95%CI:1.105~4.679,P=0.026)、联用抗生素(OR=2.092,95%CI:1.098~2.985,P=0.025)、混合感染(OR=3.002,95%CI:1.507~5.980,P=0.002)、机械通气(OR=3.519, 95%CI:1.648~7.512,P=0.000)、住ICU时间(OR=1.098,95%CI:1.058~1.140,P=0.000)是ICU中CRE感染发生的独立危险因素。结论 CRE感染影响ICU患者的预后,男性、联用抗生素、混合感染、机械通气和住ICU时间是ICU发生CRE感染的独立危险因素。
Objective To analyze the independent risk factors of Carbapenem-resistant Enterobacteriaceae(CRE) infection in intensive care unit (ICU),which in favour of providing scientific basis for preventing and controling CRE infection. Methods All the consecutive eligible patients were analyzed retrospectively from patients who were hospitalized between January 2017 and October 2018. 261 patients were included in the study and divided into two groups:a CRE group(n=147) and a Carbapenem-sensitive Enterobacteriaceae group(CSE group,n=114) based on the resistance to Carbapenems.The differences between two groups were analyzed by single-factor analysis and the independent risk factors of CRE infection were analyzed by logistic regression analysis. Results The single-factor analysis showed that the statistically significant differences were found in gender,length of stay,duration in ICU,prognosis,variety of bacteria,combined antibiotic therapy,mixed infection,artificial airway,mechanical ventilation,continuous renal replacement therapy(CRRT),blood transfusion,immunosuppressive state,coma,acute physiology and chronic health(APACHE II) score between the two groups( P <0.05).Logistic regression analysis showed that male(OR=2.273,95%CI:1.105~4.679, P =0.026),combined antibiotic therapy(OR=2.092,95%CI:1.098~2.985, P =0.025), mixed infection(OR=3.002,95%CI:1.507~5.980, P =0.002),mechanical ventilation(OR=3.519, 95%CI:1.648~7.512, P =0.000), and duration of ICU (OR=1.098,95%CI:1.058~1.140, P =0.000) were the independent risk factors of CRE infection in ICU. Conclusion CRE infection affects the prognosis of the patients in ICU.Male,combined antibiotic therapy, mixed infection, mechanical ventilation and duration of ICU are the independent risk factors of CRE infection in ICU.
作者
李琼
郭立军
王玉晶
郭伟
邓艳丽
戴新贵
Li Qiong;Guo Lijun;Wang Yujing(Chenzhou No.1 People’s Hospital,Chenzhou,Hunan 423000,China)
出处
《湘南学院学报（医学版）》
2019年第2期15-19,共5页
Journal of Xiangnan University（Medical Sciences）
基金
国家自然科学基金项目(81601708)
湘南学院校级科学研究项目(2018XJ60)
