重症监护病房多重耐药菌感染分布情况及影响因素分析  

Analysis on the distribution situation and impacting factors of multi drug resistance organism infection in intensive care unit

作　　者：曾祥泰[1] 张庆英[2] 逄楠 李艳操 许晓佳 ZENG Xiangtai;ZHANG Qingying;PANG Nan;LI Yancao;XU Xiaojia(Department of Infection Management,the First Affiliated Hospital of Shantou University Medical College,Guangdong,Shantou 515041,China;Teaching and Research Section of Public Health and Preventive Medicine,Department of Preventive Medicine,Shantou University Medical College,Guangdong,Shantou 515041,China)

机构地区：[1]汕头大学医学院第一附属医院感染管理科,广东汕头515041 [2]汕头大学医学院预防医学系公共卫生与预防医学教研室,广东汕头515041

出　　处：《中国医药科学》2024年第11期186-190,共5页China Medicine And Pharmacy

基　　金：广东省汕头市科技计划医疗卫生类别项目(230512106499561)。

摘　　要：目的分析重症监护病房(ICU)患者多重耐药菌(MDRO)感染的分布情况及其危险因素,并提出相关的预防和控制措施。方法本研究以2021年7月至2022年12月汕头市某三级甲等医院ICU收治的1407例患者为对象,回顾性收集其住院期间是否发生MDRO感染,分析MDRO感染发生率和分布情况,并分为MDRO感染组和非MDRO感染组进行比较,采用多因素logistic回归筛选MDRO感染的相关危险因素。结果ICU共有1407例住院患者均接受细菌培养及耐药菌株检测,其中男性患者为880例,女性患者为527例;MDRO感染发生率为18.69%(263/1407)。ICU中MDRO感染菌株主要涉及大肠埃希菌、金黄色葡萄球菌和肺炎克雷伯菌等。多因素分析结果显示,合并心血管病(OR=1.453,95%CI 1.006~2.079)、广谱抗生素使用时长≥1周(OR=1.900,95%CI 1.377~2.620)、使用≥2联抗生素(OR=1.913,95%CI 1.378~2.655)、留置血管内导管(OR=2.456,95%CI 1.416~3.241)与MDRO感染风险增高有关(P<0.05)。结论ICU患者中MDRO的感染发生率相对其他普通病区仍处于较高水平,应针对MDRO感染的特点和相关的高危因素及时采取预防和控制措施,有效降低MDRO的感染发生率。Objective To analyze the distribution situation and risk factors of multidrug resistant organism(MDRO)infection in patients of the intensive care unit(ICU),so as to put forward relevant prevention and control measures.Methods A total of 1407 patients admitted to the ICU of a tertiary first-class hospital in Shantou City from July 2021 to December 2022 were taken as the research object.The occurrence of MDRO infection during hospitalization was retrospectively collected,the incidence and distribution situation of MDRO infection were analyzed,and they were divided into the MDRO infection group and the non-MDRO infection group for comparison.Multivariate logistic regression was used to screen the related risk factors of MDRO infection.Results A total of 1407 inpatients of the ICU received bacterial culture and drug-resistant strains detection,including 880 male patients and 527 female patients.The incidence of MDRO infection was 18.69%(263/1407).MDRO infection strains of the ICU mainly involve Escherichia coli,Staphylococcus aureus and Klebsiella pneumoniae.The results of multivariate analysis showed that combined cardiovascular disease(OR=1.453,95%CI 1.006-2.079),duration of broad-spectrum antibiotic use was≥1 week(OR=1.900,95%CI 1.377-2.620),use of≥2 combined antibiotics(OR=1.913,95%CI 1.378-2.655),and indwelling intravascular catheters(OR=2.456,95%CI 1.416-3.241)were associated with an increased risk of MDRO infection(P<0.05).Conclusion The infection rate of MDRO of the ICU patients is still at a relatively high level compared with other general wards.According to the characteristics of MDRO infection and related high-risk factors,preventive and control measures should be taken in time to effectively reduce the infection rate of MDRO.

关 键 词：重症监护病房 多重耐药菌 感染 影响因素 

分 类 号：R446.5[医药卫生—诊断学]