老年住院患者感染耐碳青霉烯肠杆菌科细菌的耐药性和危险因素研究  

Study on the Drug Resistance and Risk Factors of Carbapenem-Resistant Enterobacteriaceae Infections in Elderly Inpatients

作　　者：杨献飞 李晓燕[2] YANG Xianfei;LI Xiaoyan(Department of Laboratory,Anyang People’s Hospital,Anyang Henan 455000,China;Department of Laboratory,Liangxiang Hospital,Fangshan District,Beijing 100000,China)

机构地区：[1]安阳市人民医院检验科,河南安阳455000 [2]北京市房山区良乡医院检验科,北京100000

出　　处：《临床研究》2024年第9期82-85,共4页Clinical Research

摘　　要：目的分析老年住院患者感染耐碳青霉烯肠杆菌科细菌的耐药情况以及危险因素,为后续治疗提供参考性依据。方法根据是否感染耐碳青霉烯肠杆菌科细菌情况将2020年8月至2023年8月入住安阳市人民医院的92例老年患者分为未感染组(46例)与感染组(46例),分析感染组细菌感染的耐药情况,对比老年患者一般资料,并将有差异项代入二元Logistic回归方程进行计算,以分析老年患者感染耐碳青霉烯肠杆菌科细菌的危险因素情况。结果耐碳青霉烯肠杆菌科细菌对绝大多数β-内酰胺类抗菌药物具有较高的耐药性,对氨苄西林/舒巴坦、氨曲南与头孢唑林均表现为绝对的耐药性;而对阿米卡星、甲氧苄啶/磺胺甲噁唑敏感性偏高。两组性别与年龄差异无统计学意义(P>0.05),两组合并基础性疾病、侵袭性操作、反复感染史、抗菌药物使用史与入院前一年住院次数差异具有统计学意义(P<0.05),且均是感染耐碳青霉烯肠杆菌科细菌的危险因素。结论老年住院患者中感染耐碳青霉烯肠杆菌科细菌对β-内酰胺类抗菌药物具有较高的耐药性,其中,影响老年住院患者出现耐碳青霉烯肠杆菌科细菌感染的因素包括合并基础性疾病、侵袭性操作、反复感染史、抗菌药物使用史与入院前一年住院次数增多等,在临床中应加强对危险因素的干预,避免不必要侵袭操作,减少感染发生。Objective To analyze the drug resistance and risk factors of carbapenem-resistant Enterobacteriaceae infections in elderly inpatients,providing a reference for subsequent treatment.Methods Ninety-two elderly patients admitted to Anyang People’s Hospital from August 2020 to August 2023 were divided into a non-infected group(46 cases)and an infected group(46 cases)based on whether they were infected with carbapenem-resistant Enterobacteriaceae.The drug resistance of the bacteria in the infected group was analyzed,and the general data of the elderly patients were compared.The variables with differences were included in a binary logistic regression model to analyze the risk factors for carbapenem-resistant Enterobacteriaceae infections in elderly patients.Results carbapenem-resistant Enterobacteriaceae showed high resistance to mostβ-lactam antibiotics,with absolute resistance to ampicillin/sulbactam,aztreonam,and cefazolin.However,it showed higher sensitivity to amikacin and trimethoprim/sulfamethoxazole.There were no statistically significant differences in gender and age between the two groups(P>0.05).The differences in underlying diseases,invasive procedures,history of recurrent infections,history of antibiotic use,and the number of hospitalizations in the year before admission were statistically significant(P<0.05),and these were all risk factors for carbapenem-resistant Enterobacteriaceae infections.Conclusion carbapenem-resistant Enterobacteriaceae infections in elderly inpatients show high resistance toβ-lactam antibiotics.Factors influencing carbapenem-resistant Enterobacteriaceae infections in elderly inpatients include underlying diseases,invasive procedures,history of recurrent infections,history of antibiotic use,and increased number of hospitalizations in the year before admission.Clinical interventions should focus on these risk factors to avoid unnecessary invasive procedures and reduce the incidence of infections.

关 键 词：耐碳青霉烯肠杆菌科细菌 耐药性 危险因素 

分 类 号：R515[医药卫生—内科学]