耐碳青霉烯类肠杆菌科细菌的感染特征和危险因素分析

发布时间：2018-01-09 15:29

本文关键词：耐碳青霉烯类肠杆菌科细菌的感染特征和危险因素分析　出处：《中华医院感染学杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的研究耐碳青霉烯类肠杆菌科细菌(CRE)的感染特征、临床预后及危险因素,以提高临床对CRE感染的认识和控制干预,帮助临床用药治疗。方法采用1∶1∶1的病例-病例-对照研究方法,收集医院2013年1月-2015年6月耐碳青霉烯类肠杆菌科细菌感染患者(CRE组),碳青霉烯类抗菌药物敏感(CSE)感染患者(CSE组)和未感染大肠埃希菌或肺炎克雷伯菌的对照组,各64例,共计192个病例;回顾性分析患者的临床资料,预测耐碳青霉烯类肠杆菌科细菌感染的危险因素。结果呼吸道感染是CRE医院感染的最常见来源,占42.19%,患者的住院科室主要分布在儿科(31.25%)和危重症监护室(26.56%);通过CRE与对照组的多因素模型分析,只有气管插管和感染前抗菌药物使用是CRE感染的独立危险因素;通过CSE与对照组单因素比对分析,只有感染前抗菌药物使用是CSE感染的危险因素;气管插管和感染前抗菌药物使用是CRE感染的独立危险因素,也是CRE感染区别于CSE感染的危险因素;64例CRE患者中12例死亡,病死率为18.75%。结论新生儿、儿童和重症患者是CRE感染的易感人群;CRE最常见感染部位为呼吸道;感染前抗菌药物使用与气管插管和CRE感染相关,是CRE感染区别于CSE感染的特有危险因素。
[Abstract]:Objective to study the infection characteristics, clinical prognosis and risk factors of Enterobacteriaceae (Enterobacteriaceae) resistant to carbapenem, so as to improve the clinical understanding and control of CRE infection. Methods 1: 1: 1: 1 case-control study was used. The patients with enterobacteriaceae infection resistant to carbapenem from January 2013 to June 2015 were collected. CSE group (n = 64) and control group (n = 64) without Escherichia coli or Klebsiella pneumoniae (n = 192); Results Respiratory tract infection was the most common source of CRE nosocomial infection, accounting for 42.19%. The inpatient departments were mainly distributed in paediatrics (31.25) and critical intensive care units (26.56%). According to the multivariate model analysis of CRE and control group, only tracheal intubation and the use of antibiotics before infection were independent risk factors of CRE infection. By comparing the single factor of CSE with that of the control group, only the use of antibiotics before infection was the risk factor of CSE infection. Tracheal intubation and the use of antibiotics before infection are independent risk factors for CRE infection and are also risk factors for differentiating CRE infection from CSE infection. 12 of 64 patients with CRE died with a mortality rate of 18.75.ConclusionNeonates, children and severe patients are susceptible to CRE infection. The most common site of CRE infection was respiratory tract. The use of antibiotics before infection is associated with tracheal intubation and CRE infection, which is a unique risk factor for CRE infection and CSE infection.
【作者单位】：广东省人民医院广东省医学科学院检验科;
【基金】：广东省省级科技计划项目(2015A050502033)
【分类号】：R446.5
【正文快照】： 碳青霉烯类抗菌药物是抗菌谱最广、抗菌活性最强的治疗革兰阴性菌的广谱抗菌药物等[1]。近年来,随着碳青霉烯类抗菌药物的广泛应用,对碳青霉烯类药物耐药的肠杆菌科细菌分离率逐年上升,导致患者的治疗变得十分困难,住院时间延长,且病死率高[2-3]。本研究分析医院耐碳青霉烯类

【相似文献】