产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌所致医院感染的危险因素分析

目的:分析产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌(ESBLs-EK)所致医院感染的危险因素。方法:以2008-2010年产ESBLs-EK所致医院感染的84例患者为病例组,同期168例非产ESBLs-EK所致医院感染的患者为对照组,采用单因素和多因素Logistic回归分析其危险因素。结果:单因素分析表明,气管插管或切开,体内留置导管,含酶抑制剂、喹诺酮类、第3代头孢菌素类的应用是产ESBLs-EK所致医院感染的危险因素;多因素Logistic回归分析表明,气管插管或切开,含酶抑制剂、喹诺酮类及第3代头孢菌素类的应用是独立的危险因素。结论:ESBLs-EK所致医院感染的危险因素为多种,主要与抗菌药物如含酶抑制剂、喹诺酮类、第3代头孢菌素类的使用及侵袭性操作有关。

Analysis of Risk Factors of Nosocomial Infection Due to ESBLs-producing Escherichia coli and Klebsiella pneumoniae

OBJECTIVE：To analyze the risk factors of nosocomial infection due to ESBLs-producing Escherichia coli（E.coli）and Klebsiella pneumoniae（K.pneumoniae）.METHODS：84 cases of nosocomial infection due to ESBLs-producing E.coli and K.pneumoniae and 168 cases of nosocomial infection which was not resulted from ESBLs-producing E.coli and K.pneumoniae were collected from 2008 to 2010 as case group and control group,respectively.The risk factors were analyzed by single factor and multiple factor Logistic regression analysis.RESULTS：Single factor analysis showed that the risk factors of nosocomial infection due to ESBLs-producing E.coli and K.pneumoniae were tracheal intubation or tracheotomy,indwelling catheter in vivo,use of lactamases inhibitor,quinolones and the third generation cephalosporins;while multiple factor Logistic regression analysis showed that tracheal intubation or tracheotomy,use of lactamases inhibitor,quinolones and the third generation cephalosporins were the independent risk factors of nosocomial infection due to ESBLs-producing E.coli and K.pneumoniae.CONCLUSION：Nosocomial infection due to ESBLs-producing E.coli and K.pneumoniae could attribute to multiple factors,which is mainly associated with use of antibiotics such as lactamases inhibitor,quinolones and the third generation cephalosporins,and invasive manipulation.