ICU多重耐药菌医院感染的危险因素分析

发布时间：2018-03-14 02:11

本文选题：重症监护病房　切入点：多重耐药菌　出处：《中国药房》2017年14期 　论文类型：期刊论文

【摘要】：目的:探讨重症监护病房(ICU)发生多重耐药菌医院感染的危险因素,为ICU多重耐药菌的防控提供参考。方法:采用回顾性研究方法,选择2011年1月-2015年12月西安航天总医院(以下简称"我院")ICU医院感染患者246例,根据药敏试验结果分为非多重耐药菌感染组(140例)和多重耐药菌感染组(106例),分析多重耐药菌组患者多重耐药菌的检出和耐药情况,并采用单因素分析和二元Logistic回归分析对发生多重耐药菌医院感染的危险因素进行探讨。结果:2011-2015年,106例多重耐药菌感染患者共分离出多重耐药菌435株,以革兰氏阴性菌为主(占89.43%),且整体耐药情况较为严重。单因素分析显示,ICU住院时间、低蛋白血症、急性脑血管疾病、肾功能异常、有创机械通气时间、动静脉置管时间、留置导尿管时间、留置胃管时间、应用抗菌药物种类、应用抗菌药物时间、抗菌药物联合应用、应用碳青霉烯类抗菌药物、应用第三代头孢菌素与多重耐药菌医院感染有关(P0.05);二元Logistic回归分析显示,急性脑血管疾病、应用抗菌药物种类、应用抗菌药物时间是ICU多重耐药菌医院感染的独立危险因素[比值比分别为2.816、1.582、1.265,95%置信区间分别为(1.540,5.151),(1.085,2.306),(1.131,1.415)]。结论:对ICU多重耐药菌感染的高危患者,应采取积极的防控和干预措施,以降低多重耐药菌医院感染发生率,提高医疗质量。
[Abstract]:Objective: to investigate the risk factors of multidrug resistant bacteria nosocomial infection in intensive care unit (ICU), and to provide reference for the prevention and control of ICU multidrug resistant bacteria. From January 2011 to December 2015, a total of 246 patients with nosocomial infection in Xi'an Aerospace General Hospital (hereinafter referred to as "our hospital") were selected. According to the results of drug sensitivity test, 140 cases of non-multidrug resistant bacteria infection group and 106 cases of multidrug resistant bacteria infection group were divided into two groups. The detection and resistance of multidrug resistant bacteria in multidrug resistant bacteria group were analyzed. Single factor analysis and binary Logistic regression analysis were used to study the risk factors of multidrug resistant bacteria nosocomial infection. Results 435 strains of multidrug resistant bacteria were isolated from 106 patients with multidrug resistant bacteria infection from 2011 to 2015. Gram-negative bacteria were the main bacteria (89.43%), and the overall drug resistance was serious. Univariate analysis showed that ICU hospitalization time, hypoproteinemia, acute cerebrovascular disease, abnormal renal function, invasive mechanical ventilation time, and arteriovenous catheterization time. The time of indwelling catheter, the time of indwelling gastric tube, the kinds of antimicrobial agents, the time of using antibiotics, the combined application of antimicrobial agents, the application of carbapenem antibiotics, The third generation cephalosporins and multidrug resistant bacteria were associated with nosocomial infection (P0.05). Binary Logistic regression analysis showed that in acute cerebrovascular diseases, antimicrobial agents were used. Antimicrobial time was an independent risk factor for hospital infection of ICU multidrug resistant bacteria [the ratio ratio was 2.816 / 1.582n 1.265 / 95% confidence interval respectively = 1.54055.151C = 1.085 / 2.306U / 1.131 / 1.415]. Conclusion: active prevention, control and intervention measures should be taken in high risk patients with ICU multidrug resistant bacteria infection. In order to reduce the incidence of multidrug resistant bacteria nosocomial infection and improve the quality of medical treatment.
【作者单位】：西安航天总医院药剂科;西安交通大学医学院第一附属医院药学部;
【分类号】：R459.7

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