2018—2020年泰州市某医院烧伤科患者多重耐药菌感染危险因素分析  

Risk factors of multidrug- resistant bacterial infection in burn unit patients of a hospital in Taizhou from 2018 to 2020

作　　者：滕支梅 纪赓 黄劲华 梁宗敏[1] 袁春琴 孔旭辉[1] TENG Zhimei;JI Geng;HUANG Jinhua;LIANG Zongmin;YUAN Chunqin;KONG Xuhui(Department of Nosocomial Infection,Taizhou People s Hospital,Taizhou 225300,China;Department of Burn,Taizhou People s Hospital,Taizhou 225300,China)

机构地区：[1]泰州市人民医院感染管理科,江苏泰州225300 [2]泰州市人民医院烧伤科,江苏泰州225300

出　　处：《东南大学学报（医学版）》2022年第6期812-817,共6页Journal of Southeast University(Medical Science Edition)

基　　金：泰州市科技计划项目(TS202036)。

摘　　要：目的:分析2018—2020年泰州市某医院烧伤科患者多重耐药菌(MDROs)感染危险因素,为降低临床MDROs感染率提供理论依据。方法:回顾性选择泰州市某医院感染管理科杏林监测系统中2018—2020年烧伤科住院患者医院感染病例信息,采用多因素Logistic回归分析感染相关危险因素。结果:871例患者中,有60例发生MDROs感染,感染发生率为6.89%,共发生115例次,例次率13.22%。MDROs感染患者检出病原菌230株,排名前三的是肺炎克雷伯菌、鲍曼不动杆菌和金黄色葡萄球菌。感染部位以伤口创面为主,占61.74%。单因素分析结果表明,糖尿病、抗菌药物使用种类及时间、创面性质、手术史、首次手术后预防性使用抗菌药物、使用呼吸机、中心静脉置管、尿管插管9个因素与感染发生有关(P<0.05)。多因素Logistic回归分析结果显示,糖尿病(OR=8.24)、抗菌药物联合使用种类(OR=4.10)、抗菌药物使用时间(OR=7.49)、尿管插管(OR=5.49)是烧伤科住院病人MDROs感染的危险因素(P<0.05)。结论:烧伤科患者的临床诊疗活动中应规范抗菌药物的使用,重点关注基础疾病患者,减少侵入性操作。Objective: To investigate the risk factors of multi-drug resistant organisms(MDROs) infection in burn unit patients from 2018 to 2020, and to provide theoretical basis for reducing clinical MDROs infection. Methods: The information of nosocomial infection cases in the burn unit inpatients from 2018 to 2020 was retrospectively selected from the monitoring system of Taizhou People’s Hospital, and the infection-related risk factors were analyzed by multivariate Logistic regression. Results: Among 871 patients, 60 patients developed MDROs infections, with an infection rate of 6.89%, and 115 times of case infection occurred, with a rate of 13.22%. A total of 230 strains of pathogenic bacteria were detected in MDROs infected patients, and the top three were Klebsiella pneumoniae, Acinetobacter baumannii and Staphylococcus aureus. The site of infection was predominantly featured by wound surface, accounting for 61.74%. The results of univariate analysis showed that 9 factors, including diabetes, time of using antibacterial drugs, days of use of antibiotics, wound surface, surgical history, prophylactic use of antibiotics after the first operation, use of ventilator, central venous catheterization and indwelling urinary catheter, were related to the occurrence of infection(P<0.05). Multivariate Logistic regression analysis showed that diabetes(OR=8.24), types of antibacterial drugs used(OR=4.10), time of using antibacterial drugs(OR=7.49) and indwelling urinary catheter(OR=5.49) were risk factors for MDROs infection. Conclusion: The use of antibiotics should be regulated in clinical diagnosis and treatment activities for burn unit patients. It is necessary to focus on patients with underlying diseases and reduce invasive operations.

关 键 词：烧伤 病原菌 多重耐药菌 危险因素 

分 类 号：R63[医药卫生—外科学]