ICU多藥耐藥菌感染現(xiàn)狀與危險(xiǎn)因素分析
發(fā)布時(shí)間：2019-07-23 20:39
【摘要】：目的了解重癥監(jiān)護(hù)病房(ICU)住院患者感染多藥耐藥菌(MDROs)的分布特征,并分析MDROs感染相關(guān)危險(xiǎn)因素,為其預(yù)防與控制工作提供參考依據(jù)。方法對(duì)醫(yī)院2014年1月-2015年1月ICU收治的17 659例患者進(jìn)行目標(biāo)性監(jiān)測,分析MDROs感染率及分布,采用法國生物梅里埃公司VITEK系統(tǒng)對(duì)病原菌進(jìn)行鑒定及藥敏試驗(yàn),依據(jù)美國臨床和實(shí)驗(yàn)室標(biāo)準(zhǔn)化研究所(CLSI)標(biāo)準(zhǔn)對(duì)結(jié)果進(jìn)行判定;采用多因素非條件logistic回歸分析MDROs感染的相關(guān)危險(xiǎn)因素。結(jié)果 17 659例ICU住院患者中發(fā)生MDROs感染1 939例,感染率為10.98%,主要來源為社區(qū)獲得性感染;MDROs感染率較高的科室為呼吸科ICU、綜合ICU和外科ICU,分別為24.34%、17.84%和17.68%;共分離出5 165株病原菌,其中MDROs有2 418株,檢出率為46.82%,MDROs檢出率較高的為鮑氏不動(dòng)桿菌、金黃色葡萄球菌和大腸埃希菌,分別為61.93%、56.81%、42.81%;多因素非條件logistic回歸分析顯示,住院時(shí)間、呼吸機(jī)使用時(shí)間、中心靜脈插管時(shí)間和基礎(chǔ)疾病是ICU MDROs感染的獨(dú)立危險(xiǎn)因素。結(jié)論 ICU患者M(jìn)DROs的感染率及檢出率較高,鮑氏不動(dòng)桿菌為最主要的MDROs;ICU患者M(jìn)DROs感染的危險(xiǎn)因素為住院時(shí)間、呼吸機(jī)使用時(shí)間、中心靜脈插管時(shí)間和基礎(chǔ)疾病。
[Abstract]:Objective to investigate the distribution characteristics of multi-drug resistant bacteria (MDROs) in inpatients with (ICU) in intensive care unit (ICU), and to analyze the risk factors related to MDROs infection, so as to provide reference for its prevention and control. Methods 17659 patients admitted to ICU from January 2014 to January 2015 were monitored, the infection rate and distribution of MDROs were analyzed, the pathogenic bacteria were identified and tested by VITEK system of French Biological Merier Company, the results were determined according to the (CLSI) standard of American Institute of Clinical and Laboratory Standardization, and the related risk factors of MDROs infection were analyzed by multivariate unconditional logistic regression. Results among 17659 inpatients with ICU, 1939 (10.98%) had MDROs infection, the main source was community acquired infection, and the departments with high MDROs infection rate were ICU, comprehensive ICU and surgical ICU, in respiratory department, which were 24.34%, 17.84% and 17.68%, respectively. A total of 5 165 strains of pathogenic bacteria were isolated, of which 2 418 strains were MDROs, the detection rate of MDROs was 46.82%, Acinetobacter baumannii, Staphylococcus aureus and Escherichia coli were 61.93%, 56.81% and 42.81%, respectively. Multivariate unconditional logistic regression analysis showed that hospitalization time, ventilator use time, central venous catheterization time and basic diseases were independent risk factors for MDROs infection. Conclusion the infection rate and detection rate of MDROs in patients with ICU are high. Acinetobacter baumannii is the most important risk factor for MDROs infection in patients with MDROs;ICU, such as hospitalization time, ventilator use time, central venous intubation time and basic diseases.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院感染管理科;
【基金】：河南省衛(wèi)計(jì)委醫(yī)學(xué)科技攻關(guān)基金資助項(xiàng)目(201403039)
【分類號(hào)】：R446.5
本文編號(hào)：2518392
[Abstract]:Objective to investigate the distribution characteristics of multi-drug resistant bacteria (MDROs) in inpatients with (ICU) in intensive care unit (ICU), and to analyze the risk factors related to MDROs infection, so as to provide reference for its prevention and control. Methods 17659 patients admitted to ICU from January 2014 to January 2015 were monitored, the infection rate and distribution of MDROs were analyzed, the pathogenic bacteria were identified and tested by VITEK system of French Biological Merier Company, the results were determined according to the (CLSI) standard of American Institute of Clinical and Laboratory Standardization, and the related risk factors of MDROs infection were analyzed by multivariate unconditional logistic regression. Results among 17659 inpatients with ICU, 1939 (10.98%) had MDROs infection, the main source was community acquired infection, and the departments with high MDROs infection rate were ICU, comprehensive ICU and surgical ICU, in respiratory department, which were 24.34%, 17.84% and 17.68%, respectively. A total of 5 165 strains of pathogenic bacteria were isolated, of which 2 418 strains were MDROs, the detection rate of MDROs was 46.82%, Acinetobacter baumannii, Staphylococcus aureus and Escherichia coli were 61.93%, 56.81% and 42.81%, respectively. Multivariate unconditional logistic regression analysis showed that hospitalization time, ventilator use time, central venous catheterization time and basic diseases were independent risk factors for MDROs infection. Conclusion the infection rate and detection rate of MDROs in patients with ICU are high. Acinetobacter baumannii is the most important risk factor for MDROs infection in patients with MDROs;ICU, such as hospitalization time, ventilator use time, central venous intubation time and basic diseases.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院感染管理科;
【基金】：河南省衛(wèi)計(jì)委醫(yī)學(xué)科技攻關(guān)基金資助項(xiàng)目(201403039)
【分類號(hào)】：R446.5
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1 袁智慧;何勤;陳毅;袁靜;;綜合ICU患者多藥耐藥菌感染分析[J];中華醫(yī)院感染學(xué)雜志;2014年15期
2 ;[J];;年期
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