非机械通气医院获得性肺炎患者多药耐药菌感染的危险因素分析  

Risk factors for infections caused by multi-drug resistant bacteria in nonventilated patients with hospital-acquired pneumonia

作　　者：石喆[1] 张灵娟[1] 程知音[1] 张韵[1] 胡斌[1] 

机构地区：[1]惠州市第一人民医院呼吸内科,广东惠州516003

出　　处：《中华医院感染学杂志》2015年第15期3414-3415,3442,共3页Chinese Journal of Nosocomiology

基　　金：广东省医学科研基金资助项目(A2011067)

摘　　要：目的分析非机械通气患者医院获得性肺炎(HAP)多药耐药菌(MDROs)感染的危险因素,以降低HAP的发生率。方法回顾性研究2010年1月-2013年6月收治的167例HAP患者的发病情况,其中75例为MDROs感染组,92例为MDROs非感染组,均未行机械通气;分析HAP患者MDROs感染的相关危险因素,采用SPSS 19.0软件进行统计分析。结果 167例非机械通气HAP患者中有75例为MDROs感染,感染率44.9%;共检出211株病原菌,90株为MDROs;多因素分析显示,两周内使用过广谱抗菌药物、住院时间>5d及慢性阻塞性肺疾病(COPD)患者为非机械通气HAP患者MDROs感染的独立危险因素(P<0.05)。结论合理使用抗菌药物、减少住院时间、有效预防治疗COPD,可以减少MDROs感染所致的HAP发生。OBJECTIVE To analyze risk factors for the development of hospital‐acquired pneumonia （HAP） caused by multi‐drug resistant bacteria （MDROs） in non‐ventilated patients .METHODS This retrospective observational cohort study was conducted on 167 HAP patients from Jan .2010 to Jun .2013 ,75 patients of them were set as the infection group and 92 as the non‐infection group .Neither group received mechanical ventilation .Logistic re‐gression analysis was used to determine risk factors for HAP caused by MDROs .The software SPSS 19 .0 was used for statistical analysis .RESULTS Of the 167 patients diagnosed with HAP ,75 （44 .9% ） were infected with MDROs strains .Totally 211 pathogenic strains were detected ,including 90 strains of MDROs .Multivariate anal‐ysis showed that the use of antibiotics within the last 2 weeks before the diagnosis of HAP ,hospital stay 〉5 d and chronic obstetric pulmonary disease （COPD） were the independent risk factors of infections caused by MDROs （P〈0 .05） .CONCLUSION The rational use of antibiotics ,shortening hospital stay and effectively prevention of COPD can reduce HAP caused by MDROs .

关 键 词：医院获得性肺炎 多药耐药菌 危险因素 

分 类 号：R378[医药卫生—病原生物学]