呼吸内科住院患者多重耐药菌监测与危险因素分析

目的分析呼吸内科多重耐药菌(MDRB)的分布及其危险因素,从而采取相应措施预防及控制多重耐药菌感染。方法回顾性调查2012年1月至2013年12月呼吸内科确诊下呼吸道感染患者124例,分为多重耐药组(70例)和非多重耐药组(54例),分析其多重耐药菌的分布,以单因素分析筛选出有统计学意义的相关危险因素,再通过多因素logistic回归分析方法分析多重耐药菌的独立危险因素。结果共检出多重耐药致病菌84株,多重耐药菌依次为大肠埃希氏菌、鲍曼溶血不动杆菌、肺炎克雷伯菌、铜绿假单胞菌。与MDRB密切关系的危险因素有住院时间、多种抗菌药物的使用、心脑血管疾病、气管切开/气管插管、留置尿管。结论大肠埃希氏菌是我院呼吸内科革兰阴性杆菌所致下呼吸道MDRB感染的首要致病菌,住院时间、慢性基础疾病、抗菌药物的使用、有创通气为其独立危险因素。

Monitoring of multi-resistant bacteria hospitalized patients with respiratory medicine and risk factor analysis

Objective To investigate the distribution and risk factors caused by respiratory medicine of mul-tiple drug-resistant bacteria ( MDRB) and to provide evidence for prevention and controlling measure of MDRB infec-tion. Methods 124 cases infected in lower respiratory tract from January 2012 to December 2013 was performed, and divided into MDRB infections group (70 cases) and the non-MDRB infections group (54 cases). Several statisti-cally significant risk factors were screened out with single factor analysis, thereafter independent risk factors of MDRB infections were determined with multivariate logistic regression analysis. Results A total of 84 pathogens were detec-ted, the pathogens successively were Escherichia coil, acinetobacter baumannii, Klebsiella pneumoniae, and pseudo-monas aeruginosa. In the multi-variable logistic analysis results of MDRB infections, the related factors included du-ration of hospital stay, use of multiple antimicrobial drug, cardiovascular and cerebrovascular diseases, tracheotomy/trachea cannula and indwelling catheter. Conclusion E. coli bacterium is the main pathogen causing MDRB in lower respiratory tract infection of gram-negative bacilli primary pathogenic bacteria. The independent risk factors of MDRB infection include duration of hospital stay, basic chronic diseases, the use of antibiotics and invasive ventilation.