下呼吸道碳青霉烯耐药革兰阴性杆菌感染危险因素分析  

Risk Factors of Carbapenem-resistant Organism Infection in Lower Respiratory Tract

作　　者：王瑶 李响 孙雪 余慧冉 王勇[1] Wang Yao;Li Xiang;Sun Xue;Yu Huiran;Wang Yong(The First Affiliated Hospital of Jiamusi University,Jiamusi 154007;Affiliated Hospital of Weifang Medical College,Weifang 261031;Changchun Dirui Medical Technology Company Limited by Shares,Changchun 130000;Dongfeng Stomatological Hospital Affiliated to Hubei Medical College,Shiyan 442000,China)

机构地区：[1]佳木斯大学附属第一医院,黑龙江佳木斯154007 [2]潍坊医学院附属医院,山东潍坊261031 [3]长春迪瑞医疗科技股份有限公司,吉林长春130000 [4]湖北医药学院附属东风口腔医院,湖北十堰442000

出　　处：《广东化工》2020年第15期39-40,42,共3页Guangdong Chemical Industry

摘　　要：目的研究下呼吸道感染患者碳青霉烯耐药革兰阴性杆菌(Carbapenem-resistant Organism,CRO)感染的临床特征及危险因素。方法回顾性收集下呼吸道CRO感染患者(111例)和碳青霉烯敏感革兰阴性杆菌(CSO)患者(58例)临床相关资料,探究下呼吸道感染患者获得CRO医院感染的危险因素。结果CRO患者以鲍曼不动杆菌、铜绿假单胞菌及肺炎克雷伯菌检出为主,科室以ICU检出为主。经分析,碳青霉烯类、氨基糖苷类、联合用药、ICU入住>7 d、呼吸系统疾病、神经系统疾病、肠外营养、免疫抑制剂、留置尿管、机械通气方面有统计学意义。多因素分析结果表明氨基糖苷类、ICU入住>7 d以及留置尿管为下呼吸道CRO感染的独立危险因素。结论下呼吸道CRO感染患者用药种类较多,大多接受侵入性操作,ICU入住时间较长且大多数伴有基础疾病,筛选独立危险因素可以更有效的制定临床诊疗方案,有助于临床感染防控。Objective To study the clinical features and risk factors of carbapenem-resistant organism(CRO)infection in patients with lower respiratory tract infection.Methods The clinical data of patients with lower respiratory tract CRO infection(111 cases)and carbapenem-sensitive organism(CSO)(58 cases)were retrospectively collected to explore the risk factors of CRO hospital infection in patients with lower respiratory tract infection.Results Patients with CRO were mainly detected by Acinetobacter baumannii,Pseudomonas aeruginosa and Klebsiella pneumoniae,and the department was mainly detected by ICU.After analysis,carbapenems,aminoglycosides,combination medication,ICU stay>7 days,respiratory diseases,neurological diseases,parenteral nutrition,immunosuppressants,indwelling urinary catheters,and mechanical ventilation are statistically significant.The results of multivariate analysis showed that aminoglycosides,ICU stay>7 days and indwelling urinary catheter were independent risk factors for CRO infection of lower respiratory tract.Conclusion Patients with CRO infection in the lower respiratory tract have more types of drugs,and most of them accept invasive procedures.ICU stays longer and most of them are associated with underlying diseases.Screening independent risk factors can make more effective clinical diagnosis and treatment plans and help prevent and control clinical infections.

关 键 词：碳青霉烯耐药 下呼吸道感染 危险因素 

分 类 号：TQ[化学工程]