肿瘤患者碳青霉烯类耐药肺炎克雷伯菌感染的危险因素分析  

Risk factors of carbapenem-resistant Klebsiella pneumoniae infection in tumor patients

作　　者：章惠萍[1] 何小帆[1] 汤莉[1] Zhang Huiping;He Xiaofan;Tang Li(Clinical Laboratory,Hangzhou Cancer Hospital,Hangzhou 310002,China)

机构地区：[1]杭州市肿瘤医院检验科,杭州310002

出　　处：《中华临床感染病杂志》2023年第6期452-456,共5页Chinese Journal of Clinical Infectious Diseases

基　　金：浙江省基础公益研究计划项目(LGF19H310001)。

摘　　要：目的分析肿瘤患者碳青霉烯类耐药肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)感染的危险因素,为临床防治提供依据。方法收集杭州市肿瘤医院2021年1月至2022年12月感染肺炎克雷伯菌(Klebsiella pneumoniae,KP)的住院肿瘤患者资料,并进行回顾性分析。根据药物敏感性试验分为CRKP组(n=37)和碳青霉烯类敏感肺炎克雷伯菌(carbapenem-sensitive Klebsiella pneumoniae,CSKP)组(n=142),采用多因素Logistic回归分析患者CRKP感染的危险因素。结果单因素分析显示,患有心血管疾病(χ^(2)=4.554,P=0.033),使用碳青霉烯类药物≥7 d(χ^(2)=53.483,P<0.001)和住院时间>7 d(χ^(2)=3.871,P=0.049)是肿瘤患者发生CRKP的危险因素。多因素Logistic回归分析显示,应用碳青霉烯类药物治疗≥7 d(OR=18.280,95%CI6.533~51.147,P<0.001)是肿瘤患者发生CRKP感染的独立危险因素。结论肿瘤患者使用碳青霉烯类药物时间过长容易发生CRKP感染,临床上要加强防治,做好CRKP感染的管理。Objective To analyze the risk factors of carbapenem-resistant Klebsiella pneumoniae(CRKP)infection in tumor patients.Methods The clinical data of hospitalized tumor patients with Klebsiella pneumoniae(KP)infection admitted in Hangzhou Cancer Hospital during January 2021 to December 2022 were retrospectively analyzed.Patients were divided into CRKP group(n=37)and carbapenem-sensitive Klebsiella pneumoniae(CSKP)group(n=142)according to drug sensitivity.The risk factors of CRKP infection were analyzed by univariate and multivariate Logistic regression.Results Univariate analysis showed that cardiovascular disease(χ^(2)=4.554,P=0.033),carbapenem use≥7 days(χ^(2)=53.483,P<0.001)and hospital stay>7 days(χ^(2)=3.871,P=0.049)were significantly associated with CRKP infection in tumor patients.Multivariate Logistic analysis showed that carbapenem therapy for≥7 days(OR=18.280,95%CI 6.533-51.147,P<0.001)was an independent risk factor for CRKP infection in tumor patients.Conclusion Tumor patients with long-term use of carbapenems are prone to CRKP infection.

关 键 词：肺炎克雷伯菌 碳青霉烯类 耐药 肿瘤患者 危险因素 

分 类 号：R446.5[医药卫生—诊断学] R730.5[医药卫生—临床医学]