我国碳青霉烯类耐药肺炎克雷伯菌感染危险因素Meta分析  

Meta-analysis on risk factors for carbapenem-resistant Klebsiella pneumoniae infection in China

作　　者：唐丽玲[1] 张培金 钱丽华[1] 李燕[1] 吴群[1] 蔡东珍[1] 张晓娟 TANG Li-ling;ZHANG Pei-jin;QIAN Li-hua;LI Yan;WU Qun;CAI Dong-zhen;ZHANG Xiao-juan(Wannan Medical College Yijishan Hospital, Wuhu Anhui 241001 ,China)

机构地区：[1]皖南医学院弋矶山医院,安徽芜湖241001

出　　处：《中国消毒学杂志》2019年第3期199-202,205,共5页Chinese Journal of Disinfection

基　　金：安徽高校人文社会科学研究项目(SK2017A0217)

摘　　要：目的应用Meta分析方法探讨碳青霉烯类耐药肺炎克雷伯菌(CRKP)感染的相关危险因素,为制定CRKP感染防控策略提供依据。方法检索Pub Med、万方和中国知网(CNKI)数据库,收集2018年3月前发表的国内CRKP感染危险因素研究文献报道。采用Stata12. 0软件计算OR值及其95%CI。结果 16篇研究文献报道的研究对象为2 126例患者,纳入了26项危险因素分析。与CRKP感染相关的危险因素有15项,分别为心血管系统、肾脏和神经系统等基础疾病,动静脉置管、机械通气、气管插管/切开、留置导尿管等侵入性医疗操作,检出前使用抗菌药物及碳青霉烯类、氨基糖苷类、酶抑制剂、喹诺酮类、三代/四代头孢、抗真菌药等抗菌药物使用,近期住院史等其他因素。结论抗菌药物使用、侵入性医疗操作、近期住院史是CRKP感染的危险因素,应制定针对性干预策略,预防和减少CRKP感染发生。Objective To analyze and explore the risk factors of Carbapenem-resistant Klebsiella pneumoniae( CRKP)infection in China by meta-analysis,so as to provide scientific basis for developing prevention and control CRKP strategies.Methods Pub Med,CNKI,and Wanfang databases were used to collect studies on risk factors for CRKP infection in China up to March 2018.The OR value and its 95% confidence interval( CI) were calculated by using Stata 12.0.Results A total of 16 studies involving 2 126 patients were included and 26 risk factors were analyzed.The results showed that there were 15 risk factors associated with CRKP infection,including underlying disease such as cardiovascular system,kidney and nervous system,arteriovenous catheter use,mechanical ventilation,endotracheal intubation/tracheotomy,urinary catheter use and other invasive procedures,use of antimicrobial agents and carbapenems,aminoglycosides,enzyme inhibitor,quinolones,third or fourth generation cephalosporins,antifungal agents,prior to isolation of CRKP,prior hospitalization and other factors.Conclusion Exposure to antimicrobials,invasive procedures and prior hospitalization were associated with the development of CRKP infection.The relevant invention strategies should be performed to prevent and reduce CRKP infection.

关 键 词：碳青霉烯类 肺炎克雷伯菌 感染 危险因素 META分析 

分 类 号：R181.32[医药卫生—流行病学] R378[医药卫生—公共卫生与预防医学]