行肠外营养治疗的ICU重症患者发生抗生素相关性腹泻的影响因素分析

目的 分析行肠外营养治疗的ICU重症患者的临床资料,探讨其发生抗生素相关性腹泻(antibiotic-associated diarrhea,AAD)的影响因素.方法 行肠外营养治疗的ICU重症患者177例,发生AAD者50例为AAD组,未发生AAD者127例为非AAD组.比较2组年龄,性别比例,合并高血压、糖尿病比率...

Influencing factors of antibiotic-associated diarrhea in critically-ill patients in ICU receiving parenteral nutrition therapy

Objective To investigate the influencing factors of antibiotic-associated diarrhea(AAD)by analyzing the clinical data of critically-ill patients in ICU undergoing parenteral nutrition therapy.Methods In 177 critically-ill patients in ICU undergoing parenteral nutrition therapy,AAD occurred in 50 patients(AAD group)and the other 127 patients had no AAD(no-AAD group).The age,sex ratio,incidences of hypertension and diabetes,length of ICU stay,albumin level at admission to ICU,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,and the administration of probiotics,proton pump inhibitors and antibiotics were compared between two groups.Multivariate logistic regression analysis was used to assess the influencing factors of AAD in critically-ill patients receiving parenteral nutrition therapy.Results The incidence rate of AAD was 28.25%.The patients in AAD group((56.80±20.41)years)were older than the patients in no-AAD group((47.12±19.30)years)(P<0.05).The length of ICU stay and the duration of antibiotics administration were longer in AAD group((17.82±12.15),(13.08±8.84)d)than those in no-AAD group((9.83±7.11),(7.92±4.83)d)(P<0.05).The rates of combined administration of antibiotics,three antibiotics used simultaneously,enzyme inhibitors,antifungal,oxazolidinones and quinolones were higher in AAD group(72.00%,46.00%,80.00%,58.00%,26.00%,28.00%)than those in no-AAD group(43.31%,19.69%,62.99%,24.41%,12.60%,11.02%)(P<0.05).The age(OR=1.020,95%CI:1.000-1.041,P=0.048),the length of ICU stay(OR=1.058,95%CI:1.007-1.113,P=0.026),duration of antibiotics administration(OR=1.124,95%CI:1.062-1.189,P<0.001),combined administration of three antibiotics(OR=3.366,95%CI:1.655-6.848,P=0.001),and the adminitration of enzyme inhibitors antibiotics(OR=2.350,95%CI:1.076-5.131,P=0.032)were the influencing factors of AAD in critically-ill patients receiving parenteral nutrition therapy.Conclusion The age,length of ICU stay,duration of antibiotics administration and combined administration of antibiotics are associated with AAD in critically-ill patients in ICU receiving parenteral nutrition therapy.