耐万古霉素肠球菌医院感染危险因素分析  

Risk Factors of Nosocomial Infections Caused by Vancomycin-resistant Enterococcus

作　　者：刘坤[1] 李有信[1] 杜晓玲[1] 

机构地区：[1]首都医科大学附属北京朝阳医院,北京100020

出　　处：《中华医院感染学杂志》2007年第8期1000-1002,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨耐万古霉素肠球菌(VRE)产生并发生VRE医院感染的危险因素,及发生VRE医院感染后采取的有效隔离预防措施。方法采用病例对照研究方法,收集2003年7月-2005年12月发生的VRE引起的医院感染21例,并随机选择同时期敏感肠球菌属医院感染28例作为对照,采用单因素(t检验,χ2检验)及多因素Logistic回归进行分析,对所有发生VRE医院感染的病例实施严密的隔离措施。结果单因素分析发现,高龄、住ICU、侵入性操作、高APACHEⅡ评分、住院时间长(>30 d)、合并≥2种细菌的混合性感染及分离出VRE前接受氟喹诺酮抗菌药物、万古霉素/去甲万古霉素治疗8种因素与VRE感染有关。结论侵入性操作及使用万古霉素/去甲万古霉素是VRE感染的危险因素,严格的隔离措施可以有效控制VRE的蔓延。OBJECTIVE To investigate the risk factors for vancomycin-resistant Enterococcus （VRE） infections and their effective isolation measures. METHODS The data of 21 cases of VRE nosocomial infections were analyzed from Jul 2003 to Dec 2005 in Beijing Chaoyang Hospital; 28 cases of antibiotic-sensitive Enterococcus infection were randomized as control. T test, chi-square test and Logistic regression analysis were used for statistics. Strict measures were taken to all of the VRE infected patients. RESULTS According to univariate analysis, the factors associated with the development of VRE nosocomial infection were age, in ICU, accepted invasive operation, Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ ）, live in hospital more than 30 days, co-infection with other pathogens, and fluoroquinolone and vancomycin/norvancomycin use 15 days before isolation of VRE. Multivariate Logistic regression analysis identified two independent factors： accepted invasive operation and previous vancomycin/norvancomycin use. Spreading of VRE had not occurred. CONCLUSIONS Accepted invasive operation and previous vancomycin/norvancomycin use are independent risk factors for VRE infection. Effective measures can prevent the spread of VRE.

关 键 词：耐万古霉素肠球菌 医院感染 危险因素 侵入性操作 隔离预防 

分 类 号：R978.1[医药卫生—药品]