肺癌患者耐甲氧西林金黄色葡萄球菌医院感染危险因素分析  

Analysis of risk factors for nosocomial infections in lung cancer patients caused by methicillin-resistant Staphylococcus aureus

作　　者：陈国卿[1] 苏乘平 程熙[1] 付亚斋 

机构地区：[1]台州市博爱医院肿瘤科,浙江台州318050

出　　处：《中华医院感染学杂志》2012年第7期1370-1371,共2页Chinese Journal of Nosocomiology

摘　　要：目的分析肺癌患者医院感染耐甲氧西林葡萄球菌(MRSA)的危险因素。方法收集2004年1月-2010年10月台州市博爱医院肿瘤科90例肺癌患者资料,其中诊断为MRSA感染病例56例为感染组,对照组为同时期同病区未感染MRSA肺癌患者34例;采用纸片扩散(K-B)法进行药敏试验;MRSA的鉴定采用CLSI 2004年指定的头孢西丁法;感染组与对照组之间比较计数资料采用t检验、卡方检验及多因素logistic回归进行分析。结果 t检验、卡方检验结果提示,年龄、混合真菌感染、机械通气、使用糖皮质激素、抗菌药物联合使用为肺癌患者医院感染MRSA的相关因素;多因素logistic回归分析结果表明,混合真菌感染(OR=12.22)、机械通气(OR=8.13)、使用糖皮质激素(OR=6.98)、抗菌药物联合使用(OR=5.18)进入回归方程。结论混合真菌感染、机械通气、使用糖皮质激素、抗菌药物联合使用为肺癌患者医院感染MRSA的独立危险因素。OBJECTIVE To investigate the risk factors for nosocomial infections caused by methicillin-resistant Staphylococcus aureus（MRSA） in lung cancer patients. METHODS A total of 90 lung cancer patients admitted in our hospital from Jan. 2004 to Oct. 2010 were analyzed, including 56 cases of MRSA infection （infection group） and 34 cases of non-MRSA infection （control group）. Disk diffusion test was adopted for drug susceptibility test. Cefoxitin method recommend by the National Committee for Clinical Laboratory Standards （NCCLS, 2004） was used to identify MRSA. Chi-square test, student t-test and multivariate logistic regression analysis were performed to compare enumeration data between infection group and control group. RESULTS The factors associated with the development of MRSA nosocomial infection were age, co-infection with fungi, mechanical ventilation, use of glueocorticoids and combination of antibiotics. Multivariate logistic regression analysis identified four independent factors： co-infection with fungi （OR= 12.22）, mechanical ventilation （OR= 8. 13）, use of glucocorticoids （OR=6.98） and combination of antibiotics （OR= 5.18）. CONCLUSION Co-infection with fungi, mechanical ventilation, use of glucocorticoids and combination of antibiotics are the independent risk factors for MRSA infection in lung cancer patients.

关 键 词：耐甲氧西林葡萄球菌 肺癌患者 医院感染 危险因素 

分 类 号：R378[医药卫生—病原生物学]