ICU中革兰阴性菌血流感染的危险因素分析

发布时间：2018-03-06 22:31

本文选题：革兰阴性菌　切入点：细菌感染　出处：《重庆医学》2016年12期 　论文类型：期刊论文

【摘要】：目的分析ICU革兰阴性(G-)菌引起的血流感染的危险因素,以进行风险评估并指导用药。方法回顾性调查分析2013年1月至2014年12月武汉大学人民医院ICU诊断为G-菌血流感染的住院患者,通过Logistic回归分析筛选G-菌引起的血流感染的危险因素。结果 2013年1月至2014年12月,ICU发生血流感染172例次,其中G-菌引起者93例次。G-菌血流感染致病菌有鲍曼不动杆菌、肺炎克雷伯杆菌、鲍氏醋酸钙不动杆菌、大肠埃希菌、铜绿假单胞菌等;除大肠埃希菌主要来自于社区感染外,其他细菌均主要来自于医院感染。为区别于其他病原菌血流感染,Logistic回归分析结果显示ICU G-菌血流感染的独立危险因素有:血清降钙素原(PCT)≥10.0ng/mL(OR=60.52,P=0.001)、之前接受碳青霉烯类及三代头孢治疗(OR=16.09,P=0.03)、患病前住院天数小于2周(OR=13.79,P=0.03)、有消化系统基础疾病(OR=12.94,P=0.01)。结论武汉大学人民医院ICU科G-菌血流感染以多重耐药菌为主,血清PCT≥10.0ng/mL、之前接受碳青霉烯类及三代头孢治疗、患病前住院天数小于2周、有消化系统基础疾病是影响其发生、诊断的独立危险因素。
[Abstract]:Objective to analyze the ICU gram negative (G-) risk factors of bloodstream infections caused by bacteria, to carry out risk assessment and guiding medication. Methods: a retrospective survey from January 2013 to December 2014, the people's Hospital of Wuhan University, ICU diagnosis of bloodstream infection in hospitalized patients with G- were analyzed by Logistic regression analysis, risk factors for screening G- bloodstream infection caused by bacteria. Results from January 2013 to December 2014, ICU bloodstream infection in 172 cases, including 93 cases of G- caused by bacteria strain.G- bloodstream infections pathogens Bauman Acinetobacter, Klebsiella pneumoniae, Acinetobacter calcoaceticus baumannii, Escherichia coli, Pseudomonas aeruginosa and Escherichia coli; in addition to mainly from in the community infection, other bacteria were mainly from nosocomial infection. To distinguish it from other pathogens of bloodstream infection, Logistic regression analysis showed that independent risk factors of ICU G- bacteria bloodstream infection: Blood Qing procalcitionin (PCT) = 10.0ng/mL (OR=60.52, P=0.001), before receiving the carbapenems and three generation cephalosporin treatment (OR=16.09, P=0.03), in less than 2 weeks before the days of hospitalization (OR=13.79, P=0.03), digestive system diseases (OR=12.94, P=0.01). In ICU, multidrug resistance bacteria conclusion G- bacterial blood stream infection in people's Hospital of Wuhan University, the serum PCT is more than 10.0ng/mL, before accepting the carbapenems and three generation cephalosporin treatment, in less than 2 weeks before hospitalization, digestive system diseases are affecting its occurrence, independent risk factors for diagnosis.

【作者单位】：武汉大学人民医院医院感染管理办公室;武汉大学人民医院重症医学科;山东省东营市人民医院肿瘤科;
【基金】：中华医院感染控制研究基金(ZHYY2014-0017)
【分类号】：R459.7

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