某医院呼吸病区住院患者肺部多重耐药菌感染特点及影响因素分析  

Characteristics and risk factors of multidrug-resistant bacterial pulmonary infections in respiratory unit patients:A hospital-based study

作　　者：余良 李薇 张萌 YU Liang;LI Wei;ZHANG Meng(Department of Respiratory and Critical Care Medicine,China 19th Metallurgical Group Co.,Ltd.Employee Hospital,Panzhihua 617000,China)

机构地区：[1]中国十九冶集团有限公司职工医院呼吸与危重症医学科,攀枝花617000 [2]西部战区空军医院检验病理科,成都610000

出　　处：《传染病信息》2025年第2期186-191,共6页Infectious Disease Information

摘　　要：目的探究中国十九治集团有限公司职工医院呼吸科住院患者肺部多重耐药菌感染特点及影响因素,为临床防控提供依据。方法采用回顾性研究分析方法,选取2020年1月至2024年2月于中国十九冶集团有限公司职工医院呼吸科住院治疗的162例肺部感染患者为研究对象,根据其是否发生多重耐药菌感染分为研究组(n=86)和对照组(n=76),检测患者痰液标本的病原菌分布特点,采用纸片扩散法检测多重耐药菌的耐药性,并通过多因素Logistic回归分析多重耐药菌感染的危险因素。结果对照组共分离出病原菌81株,其中革兰阴性菌52株,占比64.19%,以铜绿假单胞菌(22.22%)和肺炎克雷伯菌(14.82%)为主:革兰阳性菌21株,占比25.93%,以肺炎链球菌(12.35%)为主;真菌8株,占比9.88%。研究组共分离出86株病原菌,其中革兰阴性菌51株,占比59.30%,以铜绿假单胞菌(27.91%)和鲍氏不动杆菌(16.28%)为主;革兰阳性菌29株,占比33.72%,以金黄色葡萄球菌(20.93%)为主;真菌6株,占比6.98%。多因素Logistic回归分析显示,住院时间(OR=2.852,95%CI:1.087~7.481)、入住ICU(OR=2.765,95%CI:1.131~6.758)、糖皮质激素治疗(OR=2.702,95%CI:1.217~6.000)、混合感染(OR=2.751,95%CI:1.146~6.607)、机械通气(OR=2.721,95%C:1.050~7.051)、血红蛋白浓度量(0R=0.355,95%C:0.150~0.841)及抗菌药物时间(OR=2.517,95%C:1.154~5.491)均与多重耐药菌感染风险存在关联(P均<0.05)。结论住院患者肺部感染多重耐药菌以革兰阴性菌为主,住院时间长、入住ICU、抗菌药物使用时间长等因素会增加多重耐药菌感染风险,临床上应密切监测多重耐药菌感染情况,根据其分布特点及相关危险因素采取针对性防控措施。Objective This study aims to investigate the characteristics and influencing factors of multidrug-resistant bacteria infections in the lungs of hospitalized patients in the respiratory department of the Staff Hospital of China No.19 Metallurgical Group Co.,Ltd.,providing a basis for clinical prevention and control.Methods Using the retrospective research analysis method,162 patients with pulmonary infection who were hospitalized in the respiratory department of the staff hospital of China No.19 Metallurgical Group Co.,Ltd.from January 2020 to February 2024 were selected as the research objects.According to whether they had multidrug-resistant bacteria infection,they were divided into the research group(n=86)and the control group(n=76).The distribution characteristics of pathogenic bacteria in sputum specimens of patients were detected.The drug resistance of multidrug-resistant bacteria was detected by the disk diffusion method.The risk factors of multidrug-resistant bacteria infection were analyzed by multivariate Logistic regression.Results total of 81 pathogenic bacteria strains were isolated from the control group,of which 52 were Gram-negative,accounting for 64.19%,predominantlyPseudomonas aeruginosa(22.22%)and Klebsiella pneumoniae(14.82%);there were 21 Gram-positive bacteria,accounting for 25.93%,mainlyStreptococcus pneumoniae(12.35%);and 8 fungi,accounting for 9.88%In the study group,86 pathogens were isolated,There were 51 Gram-negative bacteria,accounting for 59.30%,primarilyPseudomonas aeruginosa(27.91%)and Acinetobacter baumannii(16.28%);There were 29 Gram-positive bacteria,accounting for 33.72%,mostlyStaphylococcus aureus(20.93%);and 6 fungi,accounting for 6.98%.Multivariate logistic regression analysis revealed that length of stay(OR=2.852,95%Cl:1.087-7.481),admission to ICU(OR=2.765,95%Cl:1.131-6.758),glucocorticoid treatment(OR=2.702,95%Cl:1.217-6.000),mixed infection(0R=2.751,95%Cl:1.146-6.607),mechanical ventilation(OR=2.721,95%Cl:1.050-7.051),hemoglobin content(OR=0.355,95%CI:0.150-0.841)and ant

关 键 词：肺部感染 多重耐药菌 感染特点 影响因素 

分 类 号：R563[医药卫生—呼吸系统]