医院感染多药耐药菌的危险因素分析  

Risk factors for nosocomial infections caused by multidrug-resistant bacteria

作　　者：杨志刚[1] 马希涛[1] 雷小莉[1] 

机构地区：[1]河南省人民医院呼吸与危重症科,河南郑州450000

出　　处：《中华医院感染学杂志》2014年第4期835-837,共3页Chinese Journal of Nosocomiology

基　　金：河南省自然科学基金项目(496060200);河南省科技攻关计划基金项目(132102310205)

摘　　要：目的探讨医院感染多药耐药菌的临床特点及危险因素,为预防医院感染提供依据。方法回顾性分析2011年3月-2013年3月医院收治的105例医院感染患者临床资料,对多药耐药菌的分布特点、耐药性及感染危险因素等进行分析。结果 105例医院感染患者的病原菌分布主要位于下呼吸道与上呼吸道,分别占33.3%与22.9%;共检出病原菌280株,其中革兰阴性杆菌164株占58.6%,革兰阳性球菌89株占31.8%,真菌27株占9.6%;检出多药耐药菌79株,占28.2%,主要为多药耐药铜绿假单胞菌31株,占39.2%;年龄、使用机械通气、导管留置时间过长、合并慢性阻塞性肺疾病、高血压、糖尿病以及使用大量抗菌药物等是导致多药耐药菌感染的危险因素,差异有统计学意义(P<0.05)。结论医院感染主要为革兰阴性杆菌,多药耐药菌主要为铜绿假单胞菌,多种危险因素导致医院感染,值得临床借鉴。OBJECTIVE To explore the clinical characteristics and risk factors of multiple drug-resistant bacteria infections to provide the basis for the prevention of hospital infections. METHODS The clinical data of 105 patients with hospital infection from Mar 2011 to Mar 2013 were analyzed retrospectively, the distribution characteristics, drug resistance of multi-resistant bacteria and related risk factors for infections were analyzed. RESULTS Pathogen distribution of 105 patients was mainly located in the lower and upper respiratory tract, accounting for 33.3, 22.90/oo respectively 280 pathogens were detected in this study, including 164 cases of Gram-negative bacilli, accounting for 58.60//oo, 89 cases of Gram-positive cocci, accounting for 31.8/0, and 27 cases of fungi, accounting for 9.6 79 cases of multi-resistant were isolated, which accounting for 28. 2, mainly were Pseudomonas aeruginosa, with 31 cases （39. 2） Age, the use of mechanical ventilation, prolonged indwelling catheters, patients with chronic obstructive pulmonary disease, hypertension, diabetes mellitus and the overdose of antibiotics were risk factors causing a large number of multi-drug resistant infection, with statistical significance （P0.05）. CONCLUSION Nosocomial infections are mainly caused by the gram-negative bacilli, and the P. aeruginosa is the predominant species of multidrug-resistant bacteria, there are multiple risk factors for the nosocomial infections. Key words： Multi-drug-resistant Infection Risk factor

关 键 词：多药耐药 感染 危险因素 

分 类 号：R378[医药卫生—病原生物学]