危重症患者抗生素相关性腹泻的调查

Investigation on antibiotic-associated diarrhea in critical patients

目的探讨危重症患者抗生素相关性腹泻(AAD)的发病特点及危险因素。方法用多因素非条件logistic分析方法对2002年1月～2004年12月我院危重病监护室46例AAD患者进行回顾性调查及分析。结果重症监护室医院感染率10.09%,其中医院获得性消化道感染占27.33%,AAD占消化道感染的58.22%。第3代头孢菌素、克林霉素较易发生AAD,住院天数、禁食、气管插管、泌尿道插管、手术、抗生素使用时间、联合使用抗菌药物是AAD的危险因素。结论合理使用抗生素,尽量避免各种医疗干预措施,缩短住院时间,可以降低危重症患者AAD的发生率。

Objective To investigate the characteristics and the risk factors of antibiotic-associated diarrhea （AAD） in critical patients. Methods Forty-six patients with AAD, hctspitalized in intensive care units during the period from January 2002 to December 2004, were analyzed with multivariable non-conditional logistic regression. Results The hospital infection percentage in intensive care units was 10.09%. The prevalence ratio of the acquired hospital digestive tract infects was 27.33%, AAD occupied 58.22% of the digestive tract infections. The antibiotics easily causing AAD were the third generation of cephalosporin and dinimysin. The risk factors of AAD were related to the days in hcspital, fasting, endotracheal intubations, urethral intubations, operation, the time of antibiotic therapy, and the usage of combined antibiotics. Conclusions It is important for physician to availably reduce the inddence of AAD in critical illness by using antibiotics reasonably, as far as possible avoiding invasive treatments and decreasing the time of patients being in hospital.