肺炎多重耐药菌医院感染危险因素调查与分析  

Risk factors for the presence of multiple drug-resistant bacteria in patients infected with pneumonia in hospital

作　　者：林臻[1] 黄倩倩[1] 覃金爱[2] 宋英娇[3] 文珊[4] 甘永江[5] 李春凤[6] 韦中盛[7] Lin Zhen Huang Qianqian Qin Jin＇ai Song Yingjiao Wen Shan Gan Yongjiang Li Chunfeng Wei Zhongsheng(Department of Management of Hospital Infeetion, Affiliated Tumor Hospital of Guangxi Medieal University, Nanning 530021, P.R.China Department of Management of Hospital Infection, The First Affiliated Hospital of Guangxi Medical University, Nannign 530021, P.R.China Department of Management of Hospital Infection ,Guangxi Nationalities Hospital,Nannign 530001,P.R.China Department of Management of Hospital Infection,Nanning First People＇s Hospital,Nanning 530022,P.R.China Department of Management of Hospital Infection, Nanning Second People＇s Hospital, Nanning 530031, P.R.China Department of Management of Hospital Infection, The Affiliated Hospital of Guilin Medical University,Guilin 541001 ,P.R.China Department of Management of Hospital Infection, Affiliated Hospital of Youjiang Medical College for Nationalities, Baise 533000,P.R. China)

机构地区：[1]广西医科大学附属肿瘤医院感染管理科,南宁530021 [2]广西医科大学第一附属医院感染管理科,南宁530021 [3]广西壮族自治区民族医院感染管理科,南宁530001 [4]南宁市第一人民医院感染管理科,南宁530022 [5]南宁市第二人民医院感染管理科,南宁530031 [6]桂林医学院附属医院感染管理科,桂林541001 [7]右江民族医学院附属医院感染管理科,百色533000

出　　处：《中国癌症防治杂志》2016年第6期372-377,共6页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：卫生公益性行业科研专项项目(201002021);广西壮族自治区卫生厅自筹课题资助项目(Z2014584)

摘　　要：目的探讨引起肺部发生多重耐药菌(multidrug-resistant organism,MDROs)与非MDROs院内感染的危险因素,为做好医院感染管理工作提供依据。方法收集2013年4月至10月广西7所三甲医院发生的MDROs及非MDROs肺炎患者共518例,根据病原菌耐药性分为MDROs组268例,非MDROs组250例,比较两组患者MDROs感染发生的危险因素差异。结果 MDROs引起的肺炎占医院内肺炎的51.74%,ICU是MDROs院内肺炎感染的高发科室,占66.07%;logistic分析结果显示,血红蛋白含量、1个月内2类以上抗感染药物使用史是患者发生MDROs肺炎的独立危险因素(P<0.05)。结论积极预防和干预医院感染危险因素、合理使用现代诊疗技术和抗感染药物,有助于降低发生肺部MDROs和非MDROs院内感染的风险。Objective To investigate risk factors associated with multiple drug-resistant（MDR） bacteria in patients infected with pneumonia in hospital. Methods A total of 518 nosocomial cases of pneumonia at seven grade 3 hospitals in Guangxi were followed up from April to October,2013. Of these cases,268 cases were found to be positive for MDR bacteria and 250 were found to be negative. Potential differences between MDR bacteria-positive and -negative groups were analyzed in order to identify potential risk factors of MDR infection. Results MDR bacteria were detected in 51.74% of nosocomial pneumonia infections,with the prevalence of MDR highest in pneumonia cases contracted in the intensive care unit. Logistic analysis identified low hemoglobin concentration and the use of two types of antibiotics within 1 month as independent risk factors for the presence of MDR bacteria in nosocomial pneumonia infections（P〈0.05）. Conclusions Risk factors for occurrence of MDR bacteria in nosocomial cases of pneumonia should be managed more effectively in order to decrease the hospital infection rate; for example,antibiotics should be used properly.

关 键 词：多重耐药菌 肺部感染 医院感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学]