耐碳青霉烯类黏质沙雷菌医院感染的危险因素分析  

Risk factors for nosocomial infections with carbapenem-resistant Serratia marcescens

作　　者：张蓉晖[1] 黄芸[1] 张宇宇[1] 常燕子[2] 王广芬[3] 周华[1] ZHANG Rong-hui;HUANG Yun;ZHANG Yu-yu;CHANG Yan-zi;WANG Guang-fen;ZHOU Hua(*Department of Pharmacy,Ningbo Medical Center Lihuili Hospital,Zhejiang 315010,China)

机构地区：[1]宁波市医疗中心李惠利医院药学部,浙江315010 [2]宁波市医疗中心李惠利医院检验科 [3]宁波市医疗中心李惠利医院院感科

出　　处：《中国卫生检验杂志》2023年第22期2730-2733,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江省药学会药物经济学与卫生技术评估专项(2022-ZYJ12);浙江省药学会医院药学专项(2021ZYY41);宁波市医学重点学科建设项目(2022-F06)。

摘　　要：目的探讨耐碳青霉烯类黏质沙雷菌(carbapenem-resistant Serratia marcescens,CR-SMA)医院感染的危险因素,为临床CR-SMA的预防和控制提供理论依据。方法收集2016年1月一2022年12月本院医院感染的38例CR-SMA患者为实验组,同时按照1:1配对收集相同时间段及病区的碳青霉烯类敏感黏质沙雷菌(carbapenem-sen-sitive Serratia marcescens,CS-SMA)的医院感染者为对照组,分别统计2组患者的临床特点及抗菌药物使用情况,对CR-SMA医院感染的危险因素进行单因素及多因素logistic回归分析。结果单因素敏感性分析显示,医院感染CR-SMA与SMA感染前住院时间≥14d、糖尿病、合并其他细菌感染、CR-SMA感染前抗菌药物使用时间≥14d和使用呼吸机有关(P<0.05)。多因素logistic回归分析显示,使用呼吸机和SMA感染前抗菌药物使用时间≥14d是医院感染CR-SMA的独立危险因素(P<0.05)。结论使用呼吸机和抗菌药物使用时间长应引起临床重视,对高危人群进行定期监测、加强无菌操作、落实消毒隔离措施并规范使用抗菌药物,降低医院感染的发生,防止耐药菌在院内传播。Objective This paper aims to explore the risk factors for nosocomial infections with carbapenem-resistant Serratia marcescens(CR-SMA),so as to provide theoretical basis for the prevention and control of nosocomial infections with CR-SMA.Methods Thirty-eight patients with CR-SMA nosocomial infections treated from Jan.2016 to Dec.2022 were select-ed as the CR-SMA group,and thirty-eight patients associated with carbapenem-sensitive Serratia marcescens(CS-SMA)were selected at a ratio of 1:1 and assigned as the CS-SMA group.The clinical characteristics and the usage of antibiotics of the two groups were statistically analyzed.The risk factors for nosocomial infections with CR-SMA were analyzed by univariate and multivariate logistic regression analysis.Results Univariate sensitivity analysis showed that the length of hospitalization stay before SMA infection≥14 d,diabetes,other bacterial infections,the time of antibiotics before CR-SMA infection≥14 d and the use of ventilator(P<0.05).Multivariate logistic regression analysis showed that the use of ventilator and the time of antibiotics before CR-SMA infection≥14 d were independent risk factors for nosocomial infection of CR-SMA(P<0.05).Conclusion Clinical attention should be paid to the use of ventilators and antibiotics for long duration.High-risk groups should be regularly monitored,aseptic operations should be strengthened,disinfection and isolation measures should be imple-mented,and antibiotics should be standardized to reduce the occurrence of nosocomial infections and prevent the spread of drug-resistant bacteria in hospitals.

关 键 词：耐碳青霉烯类黏质沙雷菌 医院感染 危险因素 

分 类 号：R446[医药卫生—诊断学]