ICU多药耐药菌感染现状与危险因素分析
发布时间：2019-07-23 20:39
【摘要】：目的了解重症监护病房(ICU)住院患者感染多药耐药菌(MDROs)的分布特征,并分析MDROs感染相关危险因素,为其预防与控制工作提供参考依据。方法对医院2014年1月-2015年1月ICU收治的17 659例患者进行目标性监测,分析MDROs感染率及分布,采用法国生物梅里埃公司VITEK系统对病原菌进行鉴定及药敏试验,依据美国临床和实验室标准化研究所(CLSI)标准对结果进行判定;采用多因素非条件logistic回归分析MDROs感染的相关危险因素。结果 17 659例ICU住院患者中发生MDROs感染1 939例,感染率为10.98%,主要来源为社区获得性感染;MDROs感染率较高的科室为呼吸科ICU、综合ICU和外科ICU,分别为24.34%、17.84%和17.68%;共分离出5 165株病原菌,其中MDROs有2 418株,检出率为46.82%,MDROs检出率较高的为鲍氏不动杆菌、金黄色葡萄球菌和大肠埃希菌,分别为61.93%、56.81%、42.81%;多因素非条件logistic回归分析显示,住院时间、呼吸机使用时间、中心静脉插管时间和基础疾病是ICU MDROs感染的独立危险因素。结论 ICU患者MDROs的感染率及检出率较高,鲍氏不动杆菌为最主要的MDROs;ICU患者MDROs感染的危险因素为住院时间、呼吸机使用时间、中心静脉插管时间和基础疾病。
[Abstract]:Objective to investigate the distribution characteristics of multi-drug resistant bacteria (MDROs) in inpatients with (ICU) in intensive care unit (ICU), and to analyze the risk factors related to MDROs infection, so as to provide reference for its prevention and control. Methods 17659 patients admitted to ICU from January 2014 to January 2015 were monitored, the infection rate and distribution of MDROs were analyzed, the pathogenic bacteria were identified and tested by VITEK system of French Biological Merier Company, the results were determined according to the (CLSI) standard of American Institute of Clinical and Laboratory Standardization, and the related risk factors of MDROs infection were analyzed by multivariate unconditional logistic regression. Results among 17659 inpatients with ICU, 1939 (10.98%) had MDROs infection, the main source was community acquired infection, and the departments with high MDROs infection rate were ICU, comprehensive ICU and surgical ICU, in respiratory department, which were 24.34%, 17.84% and 17.68%, respectively. A total of 5 165 strains of pathogenic bacteria were isolated, of which 2 418 strains were MDROs, the detection rate of MDROs was 46.82%, Acinetobacter baumannii, Staphylococcus aureus and Escherichia coli were 61.93%, 56.81% and 42.81%, respectively. Multivariate unconditional logistic regression analysis showed that hospitalization time, ventilator use time, central venous catheterization time and basic diseases were independent risk factors for MDROs infection. Conclusion the infection rate and detection rate of MDROs in patients with ICU are high. Acinetobacter baumannii is the most important risk factor for MDROs infection in patients with MDROs;ICU, such as hospitalization time, ventilator use time, central venous intubation time and basic diseases.
【作者单位】： 郑州大学第一附属医院感染管理科;
【基金】：河南省卫计委医学科技攻关基金资助项目(201403039)
【分类号】：R446.5
本文编号：2518392
[Abstract]:Objective to investigate the distribution characteristics of multi-drug resistant bacteria (MDROs) in inpatients with (ICU) in intensive care unit (ICU), and to analyze the risk factors related to MDROs infection, so as to provide reference for its prevention and control. Methods 17659 patients admitted to ICU from January 2014 to January 2015 were monitored, the infection rate and distribution of MDROs were analyzed, the pathogenic bacteria were identified and tested by VITEK system of French Biological Merier Company, the results were determined according to the (CLSI) standard of American Institute of Clinical and Laboratory Standardization, and the related risk factors of MDROs infection were analyzed by multivariate unconditional logistic regression. Results among 17659 inpatients with ICU, 1939 (10.98%) had MDROs infection, the main source was community acquired infection, and the departments with high MDROs infection rate were ICU, comprehensive ICU and surgical ICU, in respiratory department, which were 24.34%, 17.84% and 17.68%, respectively. A total of 5 165 strains of pathogenic bacteria were isolated, of which 2 418 strains were MDROs, the detection rate of MDROs was 46.82%, Acinetobacter baumannii, Staphylococcus aureus and Escherichia coli were 61.93%, 56.81% and 42.81%, respectively. Multivariate unconditional logistic regression analysis showed that hospitalization time, ventilator use time, central venous catheterization time and basic diseases were independent risk factors for MDROs infection. Conclusion the infection rate and detection rate of MDROs in patients with ICU are high. Acinetobacter baumannii is the most important risk factor for MDROs infection in patients with MDROs;ICU, such as hospitalization time, ventilator use time, central venous intubation time and basic diseases.
【作者单位】： 郑州大学第一附属医院感染管理科;
【基金】：河南省卫计委医学科技攻关基金资助项目(201403039)
【分类号】：R446.5
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