耐碳青霉烯类肺炎克雷伯菌感染危险因素的Meta分析  

Risk factors for carbapenem-resistant Klebsiella pneumoniae infections:a meta-analysis

作　　者：曾凌 邓琼[2] 刘鹏 饶思友[2] 周芸[2] 徐珍[2] 余奇[2] 章琦 曹先伟[2] 

机构地区：[1]南昌大学公共卫生学院,江西南昌330006 [2]南昌大学第一附属医院院感科,江西南昌330006

出　　处：《中华医院感染学杂志》2017年第18期4093-4097,4122,共6页Chinese Journal of Nosocomiology

基　　金：江西省科技厅重点基金资助项目(20152ACG70015)

摘　　要：目的分析耐碳青霉烯类肺炎克雷伯菌(CRKP)医院感染的危险因素。方法检索Pubmed、Medline、Web of Science、CNKI、万方、维普、中国生物医学文献等,并辅以文献追溯和手工检索,检索日期从建库至2017年7月1日止公开发表的文献,采用Review maneger5.0软件对纳入的文献数据进行分析,NOS法评价各项研究证据等级,并用Egger法评价发表偏倚。结果共纳入14篇研究,其中英文11篇,中文3篇,研究总样本量为2392例;Meta分析CRKP感染危险因素的比值比(OR)值及其95%CI:碳青霉烯类药物使用5.76(4.20,7.90),ICU 2.17(1.56,3.01),抗菌药物的使用2.54(1.80,3.57),定植9.18(2.82,29.92),侵入性医疗操作3.53(2.57,4.85),手术5.79(2.27,14.77),住院时间4.83(1.64,14.26),机械通气4.65(1.91,11.30),基础疾病3.99(0.24,65.34),使用导尿管9.69(0.24,398.28)。结论碳青霉烯类抗生素的大量使用、入住ICU、抗菌药物的使用、定植、手术、侵入性医疗操作、住院时间、机械通气是感染CRKP的高危因素。OBJECTIVE To analyze the risk factors for nosocomial infections caused by carbapenem-resistant Klebsiella pneumoniae（CRKP）.METHODS The databases such as Pubmed,Medline,Web of Science,CNKI,Wanfang,VIP and Chinese Biomedical Literature were retrieved and supplemented by retrospective analysis of literatures and manual retrieval,the retrieval date was from the establishment of database to Jul 1,2017.The data of the included literatures were analyzed by using Review maneger 5.0 software,the grade of the study evidence was assessed by using NOS method,and the publication bias was evaluated with the use of Egger method.RESULTS Totally 14 literatures were enrolled in the study,including 11 English literatures and 3 Chinese literatures,and the total sample size was 2392 cases.The meta-analysis showed that the odds ratio（OR）values and 95% CIof the risk factors for CRKP infection were as the following：use of carbapenems 5.76（4.20,7.90）,ICU 2.17（1.56,3.01）,use of antibiotics2.54（1.80,3.57）,colonization 9.18（2.82,29.92）,invasive medical procedures 3.53（2.57,4.85）,surgery 5.79（2.27,14.77）,length of hospital stay 4.83（1.64,14.26）,mechanical ventilation 4.65（1.91,11.30）,underlying diseases 3.99（0.24,65.34）,use of urinary catheter 9.69（0.24,398.28）.CONCLUSIONThe high risk factors for the CRKP infections include the massive use of carbapenems antibiotics,ICU stay,use of antibiotics,colonization,surgery,invasive medical procedures,length of hospital stay and mechanical ventilation.

关 键 词：耐碳青霉烯类抗生素 肺炎克雷伯菌 危险因素 感染 META分析 

分 类 号：R378[医药卫生—病原生物学]