ICU洋葱伯克霍尔德菌医院下呼吸道感染危险因素及临床分析

Nosocomial Lower Respiratory Tract Infection due to Burkholderia cepacia in Intensive Care Units: Its Clinical Character and Risk Factor

目的调查重症监护病房(ICU)洋葱伯克霍尔德菌(PCE)医院下呼吸道感染(NLRTI)危险因素及临床特点,为其防治提供依据。方法对ICU内NLRTI病例进行回顾性分析,37例洋葱伯克霍尔德菌NLRTI作为观察组,43例非洋葱伯克霍尔德菌NLRTI作为对照组,用SPSS10.0软件统计分析其危险因素。结果洋葱伯克霍尔德菌NLRTI多发生于机械通气后约1周,两组在住ICU时间、机械通气、纤维支气管镜操作、联合使用抗菌药物、H2受体拮抗剂或制酸剂及深静脉穿刺差异均有统计学意义。结论住ICU时间、机械通气、纤维支气管镜操作、联合使用抗菌药物、H2受体拮抗剂或制酸剂及深静脉穿刺是洋葱伯克霍尔德菌NLRTI的重要危险因素,该菌具有多重耐药性,应根据药敏试验结果选用敏感抗菌药物。

OBJECTIVE To investigate the clinical character and risk factor of nosocomial lower respiratory tract infection （NLRTI） due to Burkholderia cepacia in intensive care units（ICU） and discuss how to control infection. METHODS The clinical data of 37 cases were reviewed and analyzed, and 43 cases with non-B, cepacia NLRTI served as control group. RESULTS The difference in ICU stay time, mechanical ventilation, bronchoscopy, H2-receptor blocker/antacid, use of antibiotics≥2 kinds and vein catheter between patients with and without B. cepacia NLRTI was statistically significant. CONCLUSIONS ICU stay time, mechanical ventilation, bronchoscopy, H2-receptor blocker/antacid, use of antibiotics≥2 kinds and vein catheter are risk factors of B. cepacia NLRTI. Susceptibility of antibiotics to B. cepacia showed multidrug resistance to which should be paid attention in ICU, respiratory tract invasive operation limitation, medical facility sterilization and rational use of antibiotics are very important.