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| 呼吸重症监护室肺部多重耐药革兰阴性菌感染的危险因素分析 |
| Analysis of risk factors of pulmonary multidrug-resistant gram-negative bacteria infection in respiratory intensive care unit |
| 投稿时间：2021-02-27 |
| DOI：10.3969/j.issn.1000-0399.2021.10.007 |
| 中文关键词: 呼吸重症监护室 肺部感染 多重耐药革兰阴性菌 危险因素 |
| 英文关键词: RICU Pulmonary infection Multidrug-resistant gram-negative bacteria Risk factors |
| 基金项目:2020年度蚌埠市科技创新指导类项目（项目编号：20200301） |
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| 中文摘要: |
| 目的 研究呼吸重症监护室（RICU）患者肺部多重耐药革兰阴性菌（MDR-GNB）感染的病原菌分布特点，探讨RICU患者肺部MDR-GNB感染的危险因素。方法 选取2018年1月至2020年12月蚌埠市第一人民医院RICU收治的149例肺部革兰阴性菌感染患者为研究对象，根据下呼吸道分泌物细菌培养及药物敏感试验结果，分多重耐药菌组（n=67）与非多重耐药菌组（n=82）。单因素和多因素分析RICU患者肺部MDR-GNB感染的危险因素。结果 149例患者共检测出革兰阴性菌159株，多重耐药菌感染者67例，MDR-GNB 76株。单因素分析显示，两组患者气管插管、机械通气>10 d、使用3种及以上抗生素、RICU住院时间>10 d的差异均有统计学意义（P<0.05）；多因素分析显示，机械通气>10 d、使用3种及以上抗菌药物、RICU住院时间>10 d是肺部MDR-GNB感染的危险因素（P<0.05）。结论 RICU患者肺部MDR-GNB感染率较高，合理使用抗生素、缩短机械通气和RICU住院时间能有效减少肺部MDR-GNB感染。 |
| 英文摘要: |
| Objective To investigate the distribution of multidrug-resistant gram-negative bacteria(MDR-GNB) of pulmonary infection in patients from Respiratory Intensive Care Unit (RICU) of First People's Hospital of Bengbu, and to explore the risk factors of patients with pulmonary MDR-GNB infection in RICU. Methods A total of 149 RICU patients with pulmonary gram-negative bacteria infection admitted to Bengbu First People's Hospital from January 2018 to December 2020 were selected as the study subjects. According to the results of bacteria culture from the secretion of lower respiratory tracts and drug sensitivity test, the patients were divided into multi-drug resistant bacteria group(n=67) and nonmulti-drug resistant bacteria group(n=82).The risk factors of patients with pulmonary MDR-GNB infection in RICU were analyzed by univariate and multivariate analysis. Results A total of 159 strains of gram-negative bacteria were isolated from 149 patients. Multi-drug resistant bacteria infection was detected in 67 cases, and 76 MDR-GNB strains were detected. Univariate analysis showed significant statistical differences between the two groups in endotracheal intubation, mechanical ventilation duration more than 10 days, usage of 3 or more antibiotics, and more than 10 days in RICU(P<0.05). Multi-factorial analysis showed that mechanical ventilation duration more than 10 days, usage of 3 or more antibiotics, and more than 10 days in RICU were risk factors for pulmonary MDR-GNB infection(P<0.05).Conclusions The infection rate of patients with pulmonary MDR-GNB in RICU is high. The rational use of antibiotics, shortening the time of mechanical ventilation and stay in RICU can effectively reduce pulmonary MDR-GNB infection. |
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