重症监护室下呼吸道感染患者多重耐药肺炎克雷伯杆菌的危险因素及预后分析

目的 探讨重症医学科(intensive care unit,ICU)下呼吸道感染多重耐药肺炎克雷伯杆菌(multidrug-resistant Klebsiella pneumoniae,MDR-KPN)耐药情况、感染的危险因素及其预后.方法 选择2018年1月至2019年12月我院ICU内住院的肺部感染患者164例...

Risk factors of Multidrug-resistant Klebsiella pneumoniae in patients with lower respiratory infection in ICU

Objective To analyze the clinical characteristics,risk and prognostic factors Multidrug-resistant Klebsiella pneumoniae(MDR-KPN)in patients with lower respiratory infection in intensive care unit(ICU).Methods A retrospective analysis was performed on 164 hospitalized patients with lower pulmonary infection in ICU of our hospital from January 2018 to December 2019.The 164 KPN isolated from the microbiological Department of our hospital and the clinical information of each strain was collected.The resistance of each KPN strain to commonly used antibiotics was statistically analyzed.According to the results of the first KPN positive bacteriological culture,the patients enrolled were divided into MDR-KPN group 74 cases and non-MDR-KPN group 90 cases.Univariate and multivariate Logistic regression analysis were performed to explore the risk factors of MDR-KPN infection.Result Of the 74 MDR-KPN susceptibility results showed that the majority of commonly used antibiotics are more serious resistance,and the drug resistance rate of cephalosporin,penicillin and carbapenems antibiotics was above 97%.Univariate analysis suggested ICU hospitalization history within 30 days,carbapenems antibiotics used≥5 d,mechanical ventilation and duration of mechanical ventilation≥5 d were the risk factors of MDR-KPN infection(P<0.05).Multivariate Logistic regression analysis revealed that length of hospital stays in ICU,Blood pH and mechanical ventilation ere independent risk factors for MDR-KPN infection(P<0.05).Conclusion Pulmonary infection of MDR-KPN in ICU is the result of multiple factors.Such multi-drug-resistant strains should be paid more attention clinically and integrated control measures on its risk factors should be made to decrease the emergence of MDR-KPN and improve treatment prognosis of the patients.