产超广谱β-内酰胺酶细菌医院感染的危险因素  

Risk Factors of Nosocomial Infection by Extended-spectrum β-Lactamase-producing Bacteria

作　　者：李向阳[1] 张楚南[1] 杨锦红[1] 金嵘[2] 周铁丽[2] 李国雄[3] 王伟[4] 

机构地区：[1]温州医学院附属第二医院,浙江温州325027 [2]温州医学院附属第一医院,浙江温州325000 [3]丽水市中心医院,浙江丽水323000 [4]丽水市人民医院,浙江丽水323000

出　　处：《中华医院感染学杂志》2002年第7期501-503,共3页Chinese Journal of Nosocomiology

基　　金：由杭州默沙东制药有限公司资助

摘　　要：目的 研究影响产超广谱β-内酰胺酶（ESBLs）细菌医院感染的危险因素,预防医院感染暴发。方法 对1999年5月～2000年5月5所医院发生的由产ESBLs细菌导致的147例医院感染病例、42例对照病例,用单因素分析和非条件logistic回归作多因素分析。结果 多因素分析结果显示再次住院、三代头孢菌素应用>3 d、联合应用抗生素、喹喏酮类抗生素使用>3 d及给氧有显著意义;ICU、外三病区、新生儿病区、呼吸病区产ESBLs细菌的感染率显著高于其他病区;各种标本的检出率无明显差异。结论 产ESBLs菌株广泛存在于临床各科,应积极开展对该菌株的监测。特别是重点感染科室应严格进行环境消毒,控制三代头孢菌素和喹喏酮类药物的使用。OBJECTIVE To investigate the risk factors of nosocomial infection of extended-spectrum β-lactamase (ESBLs)-producing bacteria, and to prevent its outbreak. METHODS One hundred and forty seven cases of nosocomical infection with positive-ESBLs bacteria and 42 control cases of negative-ESBLs bacteria were studied by non-conditional logistic regression analysis in five hospitals from 1999 to 2000. RESULTS Results from multiple-factors analysis showed that the risk factors were readmission, using third generation cephalosporins over three days, combined application of antibiotics ,quinolones over three days and oxygen inhalation. The positive rate of ESBLs-producing in ICU, the Third Surgical Unit, Neonatal Unit and Respiratory Unit was more significant than others and had not significant difference among blood, sputum, abscess and urine samples. CONCLUSIONS The ESBLs-producing bacteria widely spreaded in hospital. The surveillance for the bacteria was energetically performed. The environmental disinfection should be carried out in focal point departments. Physician must be reasonably to apply third generation cephalosporins and quinolones.

关 键 词：超广谱Β-内酰胺酶 医院感染 危险因素 细菌耐药 

分 类 号：R378[医药卫生—病原生物学] R117[医药卫生—基础医学]