ICU腦卒中相關(guān)性肺炎患者感染多重耐藥菌危險(xiǎn)因素分析及病原學(xué)研究
發(fā)布時(shí)間:2018-05-01 11:00
本文選題:重癥監(jiān)護(hù)病房 + 卒中相關(guān)性肺炎。 參考:《重慶醫(yī)學(xué)》2017年26期
【摘要】:目的探討入住ICU的腦卒中相關(guān)性肺炎(ICU-SAP)患者感染多重耐藥菌(MDRO)的危險(xiǎn)因素并分析其病原菌構(gòu)成。方法搜集2013年1月至2016年6月該院158例ICU-SAP患者的病例資料,分析MDRO感染率和其病原菌構(gòu)成,篩選ICU-SAP發(fā)生MDRO感染的影響因素。結(jié)果 158例ICU-SAP患者中有106例發(fā)生MDRO感染,感染率為67.1%。感染患者呼吸道標(biāo)本中共分離出146株MDRO,其中革蘭陽性菌31株(21.2%),革蘭陰性菌115株(78.8%)。Logistic回歸分析顯示與ICU-SAP患者感染MDRO的因素包括SAP晚發(fā)型、ICU住院時(shí)間(≥72h)、意識障礙、吞咽障礙和急性生理學(xué)及慢性健康(APACHEⅡ)評分(25分)。結(jié)論 ICU-SAP患者感染MDRO比例高且以革蘭陰性菌為主,晚發(fā)型SAP、ICU住院時(shí)間長、存在意識障礙或吞咽障礙及疾病嚴(yán)重程度偏重可增加其感染風(fēng)險(xiǎn),應(yīng)加以重視和干預(yù),以降低發(fā)病率。
[Abstract]:Objective to investigate the risk factors of multidrug resistance (MDR) infection in patients with stroke associated pneumonia (ICU-SAP) admitted to ICU and to analyze the pathogen composition. Methods data of 158 patients with ICU-SAP from January 2013 to June 2016 were collected, the infection rate of MDRO and its pathogenic bacteria were analyzed, and the influencing factors of MDRO infection in ICU-SAP were screened. Results MDRO infection occurred in 106 out of 158 patients with ICU-SAP, and the infection rate was 67.1%. A total of 146 MDROs were isolated from respiratory tract specimens of infected patients. Among them, 31 Gram-positive strains were found to be positive for MDRO, and 115 strains of Gram-negative bacteria were found to be positive for MDRO. Logistic regression analysis showed that the factors associated with MDRO infection in patients with ICU-SAP included the length of stay (鈮,
本文編號:1829029
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