耐亚胺培南肺炎克雷伯菌下呼吸道感染的危险因素分析  

Risk factors for lower respiratory tract infections caused by imipenem-resistant Klebsiella pneumoniae

作　　者：吕丹[1] 汪丽[2] 陈冬萍[3] 马红映[1] 孙士芳[1] 陈众博[1] 丁群力[1] 邓在春[1] 

机构地区：[1]浙江省宁波大学医学院附属医院呼吸内科,浙江宁波315020 [2]浙江省宁波大学医学院附属医院微生物实验室,浙江宁波315020 [3]浙江省宁波大学医学院附属医院脊柱科,浙江宁波315020

出　　处：《中华医院感染学杂志》2015年第5期981-983,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金项目(2013ZDA022);宁波市医学科技计划基金项目(2013A19)

摘　　要：目的探讨耐亚胺培南肺炎克雷伯菌(IRKP)下呼吸感染的危险因素,为临床预防与控制IRKP的传播和流行提供参考依据。方法选取医院2010年1月-2012年12月IRKP引起的下呼吸道感染32例患者作为病例组,按1∶2配对选择64例亚胺培南敏感肺炎克雷伯菌下呼吸道感染患者作为对照组,对两组患者进行对照研究,采用VITEK-2全自动微生物鉴定系统进行细菌鉴定,采用单因素分析及多因素logistic回归分析其危险因素。结果单因素分析发现,IRKP下呼吸道感染相关的危险因素有病情危重、入住ICU、住院天数≥14d、机械通气、抗菌药物使用天数≥7d、感染前抗菌药物使用≥3种、使用亚胺培南;入住ICU、机械通气、感染前抗菌药物使用≥3种、使用亚胺培南是IRKP下呼吸道感染的独立危险因素。结论加强对相关危险因素的控制,可以有效预防与减少IRKP下呼吸道感染的发生。OBJECTIVE To explore the risk factors for lower respiratory tract infections caused by imipenem‐resist‐ant K lebsiella pneumoniae so as to provide guidance for clinical prevention and control of the prevalence of the imi‐penem K .pneumoniae（IRKP） .METHODS From Jan 2010 to Dec 2012 ,totally 32 patients with lower respiratory tract infections caused by imipenem‐resistant K .pneumoniae were assigned the case group ,then ,in a 1 ：2 ratio , 64 patients with lower respiratory tract infections caused by imipenem‐sensitive K .pneumoniae were chosen as the control group .A case‐control study was conducted ,the bacterial identification was carried out by using VITEK‐2 automatic microbial identification system ,and the univariate analysis and multivariate logistic regression analysis were performed for the risk factors .RESULTS The univariate analysis showed that the related risk factors for the lower respiratory tract infections caused by imipenem‐resistant K .pneumoniae included the critical illness condi‐tion ,ICU stay ,no less than 14 days of hospital stay ,mechanical ventilation ,duration of use of antibiotics no less than 7 days ,use of no less than 3 antibiotics before infections ,and use of imipenem ;the ICU stay ,mechanical ventilation ,use of no less than 3 antibiotics before infection ,and use of imipenem were the independent risk fac‐tors for the lower respiratory tract infections caused by imipenem‐resistant K .pneumoniae .CONCLUSION It is an effective way to strengthen the control of the related risk factors so as to prevent the lower respiratory tract infec‐tions caused by the imipenem‐resistant K .pneumoniae .

关 键 词：耐亚胺培南肺炎克雷伯菌 下呼吸道感染 危险因素 

分 类 号：R378.996[医药卫生—病原生物学]