呼吸内科多重耐药菌感染的危险因素分析  

Risk factors for multidrug resistant organism infection in department of respiratory medicine

作　　者：江冬萍[1] 左素清 梁玉萍[1] 李虹[1] 

机构地区：[1]遂宁市中心医院感染管理科,四川遂宁629000

出　　处：《川北医学院学报》2016年第5期730-733,共4页Journal of North Sichuan Medical College

摘　　要：目的：探讨呼吸内科多重耐药菌分布特点及其感染的危险因素,为预防及控制其感染提供科学的指导措施。方法：回顾性分析遂宁市中心医院2014年11月至2015年11月呼吸内科住院患者中细菌培养阳性者,将其按年龄、性别匹配分为病例组和对照组,分析多重耐药菌的分布特点及耐药情况。采用Logistic回归分析对可能的危险因素进行统计学处理。结果：多重耐药菌株列于前三位的分别是大肠埃希菌27例（34.18%）、鲍曼不动杆菌16例（20.25%）、铜绿假单胞菌8例（10.13%）。大肠埃希菌对头孢替坦及亚胺培南耐药率最低,鲍曼不动杆菌表现为泛耐药,青霉素类及头孢类抗菌素在铜绿假单胞菌中耐药率较高。多因素分析显示,糖尿病（OR=6.74,95%CI：1.57-20.82）、联合应用抗生素（OR=2.98,95%CI：1.14-7.79）、机械通气（OR=3.60,95%CI：1.29-9.99）以及住院天数（OR=4.34,95%CI：1.01-9.98）与多重耐药菌感染有关联。结论：糖尿病、抗生素联合用药、机械通气、住院天数可能是多重耐药菌感染的危险因素。Objective： To investigate the distribution characteristics of multidrug resistant organisms（ MDROs） in the department of respiratory medicine and the risk factors of infection and to provide scientific evidence for the prevention and control of MDROs infections. Methods： A retrospective analysis was applied on the data from positive bacterial culture of the inpatients who lived in the department of respiratory medicine,during November 2014 to November 2015. According to the age and sex matched cases and control group,the distribution characteristics and drug resistance of multi drug resistant bacteria were analyzed. Logistic regression analysis was used to analyze the possible risk factors. Results： The result showed that the top three among the MDROs were Escherichia coli 27（ 34. 18%）,Acinetobacter baumannii 16（ 20. 25%） and Pseudomonas aeruginosa 8（ 10. 13%）. The resistance rate of Escherichia coli to furadantin was lowest. All the Acinetobacter baumannii were Pan resistance. Penicillin and cephalosporin antibiotic resistance in pseudomonas aeruginosa was higher. Multivariate analysis showed that diabetes（ OR = 6. 74,95% CI： 1. 57- 20. 82）,antibiotics combination（ OR = 2. 98,95% CI： 1. 14- 7. 79）,mechanical ventilation（ OR = 3. 60,95% CI： 1. 29- 9. 99） and days（ OR = 4. 34,95%CI： 1. 01- 9. 98） was associated with multi drug resistant organisms. Conclusion： Diabetes,Antibiotic combination,Mechanical ventilation and hospital stay may be risk factors for infections of MDROs.

关 键 词：多重耐药菌 危险因素 呼吸内科 

分 类 号：R322.3[医药卫生—人体解剖和组织胚胎学]