骨科患者尿路感染耐碳青霉烯类大肠埃希菌的耐药性及危险因素研究  

Study on drug resistance and risk factors of CREco in urinary tract infection of orthopedic patients

作　　者：江琰笛[1] 李情操[2] 陶崑[1] 张勇[1] JIANG Yan-di;LI Qing-cao;TAO Kun;ZHANG Yong(Ningbo No.6 Hospital,Ningbo Zhejiang 315040;Ningbo Medical Treatment Center Li Huili Hospital,China)

机构地区：[1]宁波市第六医院,浙江宁波315040 [2]宁波市医疗中心李惠利医院

出　　处：《中国消毒学杂志》2020年第3期216-218,共3页Chinese Journal of Disinfection

摘　　要：目的研究骨科患者尿路感染耐碳青霉烯类大肠埃希菌(CREco)的耐药性及其导致尿路感染的危险因素。方法通过回顾性调查方式,对某医院收治的尿液培养大肠埃希菌阳性骨科患者的临床资料进行分析,以了解患者尿路感染CREco的耐药性及其危险因素。结果从该医院住院尿路感染送检标本中检出CREco菌株48例。CREco菌株对大部分常用抗菌药物的耐药率高于大肠埃希菌碳青霉烯类敏感株(P <0. 05)。多因素分析结果显示,入住ICU、入住ICU> 1周、留置导尿时间> 14 d、近1个月使用碳青霉烯类抗菌药物、住院时间> 30 d等因素构成骨科患者CREco尿路感染的独立危险因素。结论骨科患者尿路感染CREco耐药情况严重,应采取有效的防控措施,降低CREco所致尿路感染的风险。Objective To investigate the drug resistance of carbapenem-resistant Escherichia coli( CREco) in urinary tract infection of orthopedic patients and the risk factors of urinary tract infection. Methods The clinical data of urinary cultured Escherichia coli-positive orthopedic patients admitted in a hospital were analyzed by retrospective survey to understand the drug resistance and risk factors of CREco in patients with urinary tract infection. Results A total of 206 strains of Escherichia coli were detected from the inpatient samples of urinary tract infections in the hospital,of which 48 were CREco strains. The resistance rates of CREco strains to most commonly used antibacterials were higher than that of carbapenem-sensitive Escherichia coli strains( P < 0. 05). Multivariate Logistic regression analysis revealed that factors such as admission to ICU,ICU stay > 1 week,indwelling catheterization time > 14 d,use of carbapenem antibiotics in recent 1 month and hospital stay > 30 days were the independent risk factors of CREco urinary tract infection in orthopedic patients. Conclusion The drug resistance of CREco in urinary tract infections of orthopedics patients is serious,and effective prevention and control measures should be taken to reduce the risk of urinary tract infections caused by CREco.

关 键 词：大肠埃希菌 耐碳青霉烯类 尿路感染 耐药性 危险因素 

分 类 号：R378[医药卫生—病原生物学]