耐万古霉素肠球菌医院感染流行特征与危险因素分析

发布时间：2018-08-19 15:04

【摘要】：目的对耐万古霉素肠球菌(VRE)医院感染现状、流行特征及相关危险因素进行分析,为制定VRE医院感染预防控制策略提供科学依据。方法收集医院2010年1月-2014年9月23例VRE医院感染患者的临床及流行病学资料,采用1∶1成组设计病例对照研究,运用单因素及多因素logistic回归分析,探索VRE医院感染发生的危险因素。结果 4年共纳入2 887例住院患者,23例发生VRE医院感染,4年感染率波动较大,为0.20%~1.90%;尿路感染是VRE医院感染最常见的感染类型,占73.91%;科室分布以老年病房最高,占26.09%;8例VRE患者发生混合感染;死亡8例,病死率34.78%;多因素logistic回归分析结果显示,高龄、患有基础疾病、感染前使用过碳青霉烯类抗菌药物是VRE医院感染的独立危险因素。结论老年患者、患有基础疾病、使用碳青霉烯类抗菌药物是VRE医院感染的危险因素,VRE与真菌混合感染提示不良临床结局,临床应严格掌握广谱抗菌药物使用指征,预防VRE的发生和传播。
[Abstract]:Objective to analyze the status of nosocomial infection of vancomycin resistant Enterococcus (VRE), its epidemic characteristics and related risk factors, and to provide scientific basis for the prevention and control of VRE nosocomial infection. Methods the clinical and epidemiological data of 23 patients with VRE nosocomial infection from January 2010 to September 2014 were collected. The 1:1 case-control study was designed and the univariate and multivariate logistic regression analysis was used. To explore the risk factors of VRE nosocomial infection. Results among the 2 887 inpatients, 23 cases developed VRE nosocomial infection in 4 years, the infection rate in 4 years fluctuated greatly (0.20% 1.90), urinary tract infection was the most common infection type of VRE nosocomial infection (73.91%), and the department distribution was the highest in the geriatric ward. There were 8 cases of mixed infection in VRE, 8 cases of death, and 34.78% of mortality. The results of multivariate logistic regression analysis showed that the risk factors of VRE nosocomial infection were elderly, suffering from basic diseases and the use of carbapenes before infection. Conclusion the use of carbapenem antibiotics is the risk factor of VRE nosocomial infection. The mixed infection of VRE and fungi suggests a bad clinical outcome. The clinical indications for the use of broad-spectrum antimicrobial agents should be strictly grasped. Prevent the occurrence and spread of VRE.
【作者单位】：广东省人民医院医院感染控制医学部;
【基金】：广东省科技计划基金资助项目(2012B031800162)
【分类号】：R446.5

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