COVID-19是多重耐药菌感染/定植的危险因素吗?——COVID-19大流行期间一项住院患者多重耐药菌感染调查  

Is COVID-19 a risk factor for infection/colonization with multidrug-resistant organisms?A survey on multidrug-resistant organisms infection in hospitalized patients during the COVID-19 pandemic

作　　者：叶永康[1] 周子筌 覃金爱[1] YE Yong-kang;ZHOU Zi-quan;QIN Jin-ai(Department of Healthcare-associated Infection Management,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院医院感染管理科,广西南宁530021

出　　处：《中国感染控制杂志》2024年第10期1279-1285,共7页Chinese Journal of Infection Control

摘　　要：目的医院大规模收治新型冠状病毒感染(COVID-19)患者的状况下,分析COVID-19是否为住院患者多重耐药菌(MDRO)感染/定植的潜在危险因素。方法回顾性分析2022年12月1日-2023年1月31日某三级甲等医院的住院患者资料。比较COVID-19患者与非COVID-19患者的临床资料、抗菌药物治疗情况、MDRO检出情况。将检出病原菌的患者分为MDRO组和非MDRO组,采用多因素logistic回归分析住院患者MDRO感染/定植的危险因素。结果收治各类住院患者共16710例,其中COVID-19组2403例,8.83%(113/1280)检出MDRO;非COVID-19组14307例,4.43%(167/3770)检出MDRO。COVID-19组患者耐碳青霉烯类肺炎克雷伯菌(CRKP)检出率高于非COVID-19组(48.15%VS 30.89%,P=0.028)。多因素分析结果显示,危重患者(OR=4.796,95%CI:3.524~6.527)、培养前接受抗菌药物治疗≥2 d(OR=2.330,95%CI:1.699~3.196)、培养出真菌(OR=1.780,95%CI:1.318~2.405)、住院日数长(OR=1.036,95%CI:1.030~1.042)是住院患者MDRO感染/定植的危险因素(均P<0.05)。结论医院大规模收治COVID-19患者期间,MDRO感染/定植与是否为危重患者、抗菌药物使用、培养出真菌、住院日数长有关,COVID-19不是MDRO感染/定植的危险因素。Objective To analyze whether coronavirus disease 2019(COVID-19)is a potential risk for the infection/colonization with multidrug-resistant organisms(MDROs)in hospitalized patients during a surge admission of COVID-19 patients.Methods Data of hospitalized patients in a tertiary first-class hospital from December 1,2022 to January 31,2023 were retrospectively analyzed.Clinical data,antimicrobial therapy,and MDROs detection result between COVID-19 patients and non-COVID-19 patients were compared.Patients with detected pathogens were divided into MDRO group and non-MDRO group.Risk factors for infection/colonization with MDROs in hospitalized patients were analyzed by multivariate logistic regression.Results A total of 16710 patients were admitted in hospital,2403 cases were in COVID-19 group,and 8.83%(113/1280)were MDRO-infected cases;14307 cases were in non-COVID-19 group,and 4.43%(167/3770)were MDRO-infected cases.The detection rate of carbapenem-resistant Klebsiella pneumoniae(CRKP)in patients in COVID-19 group was higher than that in non-COVID-19 group(48.15%vs 30.89%,P=0.028).Multivariate analysis results showed that critical illness(OR=4.796,95%CI:3.524-6.527),antimicrobial therapy≥2 days before pathogen culture(OR=2.330,95%CI:1.699-3.196),positive fungi culture(OR=1.780,95%CI:1.318-2.405),long hospital stay(OR=1.036,95%CI:1.030-1.042)were risk factors for MDRO infection/colonization in hospitalized patients(all P<0.05).Conclusion During mass admission of COVID-19 patients,MDROs infection/colonization is related to critical illness,antimicrobial use,positive fungi culture and long hospital stay,while COVID-19 infection is not a risk factor for MDROs infection/colonization.

关 键 词：新型冠状病毒感染 合并感染 抗菌药物治疗 多重耐药菌 

分 类 号：R181.32[医药卫生—流行病学]