儿科重症监护室多重耐药革兰阴性菌感染危险因素  

Risk factor of multidrug-resistant Gram-negative bacteria infection in pediatric intensive care unit

作　　者：林凌洁 张丹如[1] 张玲利[1] 

机构地区：[1]温州医科大学附属第二医院育英儿童医院,浙江温州325000

出　　处：《中国消毒学杂志》2017年第10期955-958,共4页Chinese Journal of Disinfection

摘　　要：目的探讨儿科重症监护室(PICU)多重耐药革兰阴性菌(MDR-GNB)感染的危险因素,为有效防控提供参考。方法采用回顾性分析方法,对某医院PICU住院期间发生的革兰阴性菌感染病例进行调查。通过细菌培养、药敏试验结果以及logistics回归分析,对多重耐药革兰阴性菌感染的危险因素进行分析。结果 133例调查对象中,MDR-GNB组62人,非MDR-GNB组71人。回归分析发现,持续性机械通气、院内感染、烧伤或电击伤以及前期不合理的抗菌药物治疗为MDR-GNB感染的危险因素。MDR-GNB感染患儿住院时间(t=4.3,P=0.000)和住PICU(t=5.1,P=0.000)时间均显著延长,死亡率明显高于非MDR-GNB组(χ2=4.1,P=0.047)。结论 PICU内MDR-GNB感染患儿住院时间延长,死亡率增加,预后差,应针对危险因素制定干预措施。Objective To evaluated the risk factors of multidrug-resistant Gram-negative bacteria（ MDR-GNB） in our pediatric intensive care unit（ PICU）,and provide reference for effective control and prevention. Methods Retrospective analysis was used to survey Gram-negative bacteria infection in PICU. bacterial culture and drug susceptibility test and logistics regression analysis were used to analyze the risk factors of multidrug-resistant Gram-negative bacteria infection.Results 133 cases of patients were included in our study,62 cases was in MDR-GNB group and 71 cases non MDR-GNB group. Logistics regression analysis showed Continuous mechanical ventilation,hospital infections,burns or electrically damaging and the unreasonable antibiotic treatment in early stage were risk factors of MDR-GNB infection. Length of hospital stay（ t = 4. 3,P = 0. 000） and length of PICU stay（ t = 5. 1,P = 0. 000） in MDR-GNB group were significantly longer than non MDR-GNB group,and mortality of MDR-GNB group were also higher than non MDR-GNB group χ~2=4. 1,P = 0. 047）. Conclusion The patients with MDR-GNB infection have longer hospital stays,increased mortality and poor prognosis; we should strengthen counter measure according the risk factors.

关 键 词：儿科重症监护室 多耐药革兰阴性菌 医院感染 危险因素 

分 类 号：R181.3[医药卫生—流行病学]