非ICU患者耐碳青霉烯类肺炎克雷伯菌医院感染的危险因素分析  

Risk factors analysis of nosocomial infection by Carbapenem-Resistant Klebsiella pneumoniae in non-intensive care unit patients

作　　者：张会娟 郭军[1] 王立万 王利君[2] Zhang Huijuan;Guo Jun;Wang Liwan;Wang Lijun(Beijing Tsinghua Changguang Hospital, School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院呼吸内科,102218 [2]清华大学附属北京清华长庚医院检验科,102218

出　　处：《北京医学》2018年第12期1122-1125,共4页Beijing Medical Journal

摘　　要：目的了解非重症监护室(intensive care unit, ICU)耐碳青霉烯类肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae, CRKP)致医院感染的危险因素。方法收集清华大学附属北京清华长庚医院2017年1～12月普通病房(非ICU)CRKP医院感染患者31例为病例组,同期我院普通病房发生碳青霉烯类敏感肺炎克雷伯菌(carbapenem-sensitive Klebsiella pneumoniae, CSKP)医院感染患者31例为对照组,进行单因素分析和多因素logistic回归分析。结果单因素分析结果显示,CRKP0.01)、感染前住院时间≥3周(OR=60.41,P<0.01)、至少留置一种引流管(OR=17.82,P<0.01)、合并两种及以上慢性基础疾病(OR=3.49,P<0.05);多因素logistic回归分析显示,碳青霉烯类抗菌药物使用≥1周(OR=7.950,P=0.04)、感染前住院时间≥3周(OR=23.041,P=0.01)和至少留置一种引流管(OR=6.492,P=0.03)是发生CRKP医院感染的独立危险因素。结论 CRKP医院感染的独立危险因素包括碳青霉烯类抗菌药物的过度暴露、长期住院及有创导管留置。Objective To investigate the risk factors of nosocomial infection due to carbapenem-resistant Klebsiella pneumonia(CRKP) in non-intensive care unit. Methods Totally 31 cases of patients with CRKP nosocomial infection from January to December 2017 in non-intensive care unit of Beijing Tsinghua Changguang Hospital were collected as the case group. In the same period, totally 31 cases of patients with carbapenem-sensitive Klebsiella pneumonia(CSKP) nosocomial infection in non-intensive care unit were randomly selected as the control group. Univariate analysis and multivariate logistic regression analysis were performed. Results The results of univariate analysis showed that the risk factors for CRKP nosocomial infection included the use of carbapenem antibiotics ≥1 week(OR = 15.46, P<0.01), hospital stay ≥3 weeks before infection(OR = 60.41, P<0.01), at least one kind of invasive catheter(OR = 17.82, P<0.01)and combined with two or more chronic diseases(OR = 3.49, P<0.05). Multivariate logistic regression analysis indicated that the use of carbapenem antibiotics ≥1 week(OR = 7.950,P = 0.04), hospital stay ≥3 weeks before infection(OR = 23.041,P = 0.01)and at least one kind of invasive catheter(OR = 6.492,P = 0.03)were independent risk factors for CRKP nosocomial infection. Conclusions Independent risk factors for CRKP nosocomial infection include overexposure to carbapenem antibiotics, long-term hospitalization, and the use of invasive catheterization.

关 键 词：肺炎克雷伯菌 碳青霉烯类药物 医院感染 危险因素 

分 类 号：R56[医药卫生—呼吸系统]