Cox 比例风险模型分析 ESBLs 大肠埃希菌致尿路感染危险因素

目的探讨ESBLs大肠埃希菌致尿路感染的相关危险因素。方法回顾性分析尿培养结果为大肠埃希氏菌的286例尿路感染患者的临床资料，并进行ESBLs的检测，采用Cox比例风险模型分析产ESBLs大肠埃希菌致尿路感染的危险因素。结果单因素分析结果显示，ESBLs组和非ESBLs组的入住ICU、住院天数、尿管留置、免疫抑制剂、糖皮质激素、使用三代头孢菌素、泌尿系统手术之间比较，差异存在统计学意义（P〈0．05）。Cox比例风险模型分析结果显示：尿管留置（OR=1．936）、免疫抑制剂（OR=1．824）、使用三代头孢菌素（OR=2．129）是ESBLs大肠埃希菌致尿路感染的独立危险因素。结论对有尿管留置、免疫抑制剂、使用三代头孢菌素等危险因素存在的患者进行严密监测，尽量减少尿管留置等侵入性操作，控制三代头孢菌素和免疫抑制剂的使用，达到预防和控制产ESBLs大肠埃希菌尿路感染发生的目的。

Study on risk factor of ESBLs produced in urinary tract infections by COX proportional hazard model

Objective To study the risk factor of ESBLs produced in urinary tract infections. Methods Retrospective analysis of ESBLs produced in urinary tract infections from 2010 to 2012 were conducted. The risk factors of ESBLs produced in urinary tract infections were analyzed by COX proportional hazard model. Results One-way analysis indicated： there were significantly different between ESBLs group and no-ESBLs group in ICU, hospitalization day, bladder douching, immunosuppressant, glucocorticoid, using third generation cephalosporin and urinary system operations （ P 〈 0.05 ）. The COX proportional hazard model showed that bladder douching （ OR = 1. 936 ）, immunosuppressant （ OR = 1. 824 ）, using third generation eephalosporin（ OR = 2. 129） were independent risk factors of ESBLs produced in urinary tract infections. Conclusion The patients with risk factors as bladder douching,immunosuppressant, using third generation eephalosporin and so on were monitored to decrease the rates of ESBLs produced in urinary tract infections.