多重耐药菌医院呼吸机相关性肺炎危险因素及预后分析  

Risk Factors and Prognosis Analysis of Hospital Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Bacteria

作　　者：杨文馨 王祥飞[1] YANG Wenxin;WANG Xiangfei(Shanghai Traditional Chinese Medicine Hospital,Shanghai,China 200071)

机构地区：[1]上海市中医医院,上海200071

出　　处：《中国药业》2024年第S01期28-30,共3页China Pharmaceuticals

摘　　要：目的探讨多重耐药菌医院呼吸机相关性肺炎(VAP)的危险因素及预后。方法选取医院2020年1月至2021年12月收治的重症加强护理病房(ICU)机械通气患者100例,根据是否发生VAP分为VAP组(下呼吸道检出多重耐药菌并符合VAP临床诊断标准,50例)和非VAP组(下呼吸道未检出多重耐药菌且未诊断为VAP,50例)。比较两组患者住院时间和住院费用,并分析多重耐药菌VAP发生的危险因素。结果VAP组患者治疗费用和住院时间均显著高于非VAP组(P<0.05)。引起呼吸VAP的危险因素包括意识障碍,呼吸机相关性肺炎类型为晚发型,近3个月接受第3代头孢菌素、含酶抑制剂复合物和碳青霉烯类抗菌药物,呼吸机通气时间≥7 d,ICU住院时间≥7 d(P<0.05)。结论VAP可增加患者的治疗费用和延长住院时间。造成多重耐药菌医院VAP的危险因素较多,如意识障碍,呼吸机通气时间≥7 d、晚发型呼吸机相关性肺炎,ICU住院时间≥7 d,近3个月接受第3代头孢菌素、含酶抑制剂复合物和碳青霉烯类抗菌药物,应根据相关危险因素采取综合性防控措施,降低其发生风险。Objective To investigate the risk factors and prognosis of hospital ventilator-associated pneumonia(VAP)caused by multidrug-resistant bacteria.Methods A total of 100 patients received mechanical ventilationin the intensive care unit(ICU)admitted to the hospital from January 2020 to December 2021 were selected.They were divided into the VAP group(with multi drug-resistant bacteria detected in the lower respiratory tract and meeting the clinical diagnostic criteria for VAP,50 cases)and the non-VAP group(without multi drug-resistant bacteria in the lower respiratory tract and not diagnosed with VAP,50 cases).The hospital stay and hospitalization costs of the two groups were compared,and the risk factors for the occurrence of VAP caused by multi drug-resistant bacteria were analyzed.Results The treatment costs and hospital stay in the VAP group were significantly higher than those in the non-VAP group(P<0.05).The risk factors for VAP included consciousness disorders,late onset VAP,receiving third-generation cephalosporins,enzyme inhibitor complex and carbapenem antibiotics in the past three months,and ventilation time≥7 d,ICU hospitalization time≥7 d(P<0.05).Conclusion VAP can increase treatment costs and prolong hospital stay for patients.There are many risk factors for hospital VAP caused by multidrug-resistant bacteria,such as cognitive impairment,ventilation time≥7 d and late onset VAP,ICU hospitalization time≥7 d,receiving third-generation cephalosporins,enzyme inhibitor complex and carbapenem antibiotics in the past three months.Comprehensive prevention and control measures should be taken according to relevant risk factors to reduce the risk of multidrug-resistant bacterial infections.

关 键 词：多重耐药菌 医院 呼吸机相关性肺炎 危险因素 预后 

分 类 号：R563.1[医药卫生—呼吸系统]