多重耐药肺炎克雷伯菌感染的危险因素及治疗方案比较

发布时间：2018-07-01 18:50

  本文选题：多重耐药肺炎克雷伯菌 + 感染高危因素　； 参考：《上海交通大学学报(医学版)》2017年07期

【摘要】：目的·分析多重耐药肺炎克雷伯菌(MDR-Kpn)感染的高危因素及不同治疗方案的疗效差异。方法·收集并分离医院内110株MDR-Kpn,进行药敏试验。通过查询电子病历系统,51例患者为MDR-Kpn感染组;同病区相同基础疾病且分离到Kpn的51例患者作为对照组。对MDR-Kpn感染和对照组患者共39项临床指标进行单因素分析,对有统计学意义的变量进行多因素Logistic回归分析。将感染组患者,按治疗结局分为治疗无效组和有效组,比较抗生素使用时间。结果·药敏试验结果显示:110株MDR-Kpn对磺胺类、磷霉素和阿米卡星的敏感性较高。单因素分析结果显示:输血、有创通气、吸痰等12个临床指标为感染高危因素(P0.05)。有效组(28例)和无效组(23例)在抗生素的使用时间上比较,碳青霉烯类的差异有统计学意义(P=0.025)。结论·控制和消除高危因素对预防及减少MDR-Kpn的感染生长有积极意义;合理使用碳青霉烯类抗生素对预后有利。
[Abstract]:Objective to analyze the high risk factors of multidrug resistant Klebsiella pneumoniae (MDR-Kpn) infection and the difference of therapeutic effects. Methods 110 strains of MDR-Kpn were collected and isolated from the hospital. 51 patients with MDR-Kpn infection were investigated by the electronic medical record system, and 51 patients with the same basic diseases and Kpn were used as control group. The 39 clinical indexes of MDR-Kpn infection and control group were analyzed by univariate analysis and multivariate logistic regression analysis of statistically significant variables. The patients in the infected group were divided into two groups according to the outcome of the treatment: the ineffective group and the effective group. Results the sensitivity of MDR-Kpn to sulfonamides, fosfomycin and amikacin was higher. Univariate analysis showed that blood transfusion, invasive ventilation, sputum aspiration and other 12 clinical indicators were high risk factors of infection (P0.05). In the effective group (28 cases) and the ineffective group (23 cases), there was a significant difference in the use time of carbapenems (P0. 025). Conclusion the control and elimination of high risk factors have positive significance in preventing and reducing the infection and growth of MDR-Kpn, and the rational use of carbapenem antibiotics is beneficial to the prognosis.
【作者单位】： 上海交通大学医学院附属仁济医院检验科;
【基金】：上海青年临床医技人才培养资助计划(沪医卫基[2016]05号)~~
【分类号】：R446.5
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本文编号：2088754