抗结核抗菌药物应用与相关医院感染分析

Analysis on the application of antitubercular antimicrobial agents and related nosocomial infection

目的了解兼有广谱抗细菌作用的药物在抗结核治疗中长期、联合应用有无增加二重感染的风险。方法比较2002年1月—2005年12月某院住院的结核病患者,在抗结核方案中含利福霉素、氨基糖苷类和喹诺酮类等不同种类抗菌药物及不同用药时间,其相应医院感染发生率。结果住院>1月的患者共1 389例,发生医院感染75例(5.40%)。抗结核治疗方案中含抗菌药物组医院感染率为5.81%,高于不含抗菌药物组1.52%(χ2=4.31,P<0.05);含1种、2种、3种抗菌药物组的医院感染率分别为3.24%、5.89%、7.58%。用药时间越长感染率越高,用药1月、2月、3月患者的感染率分别为2.95%、5.18%、11.34%,两两比较,差异均具显著性(均P<0.05)。结论结核患者长期、联合应用兼有广谱抗菌作用的药物,其相关感染率增加。

Objective To investigate whether long-term and combination application of antitubercular antimicrobial agents can increase the risk of double infection in patients with tuberculosis. Methods Tuberculosis patients hospitalized from January 2002 to December 2005 received different kinds of antitubercular antimicrobial agents （such as rifamycin, aminoglycosides and quinolones）, the occurrence of nosocomial infection （NI） were compared. Results Seventy-five of 1 389（5. 40%） patients who were hospitalized〉1 months occurred NI, NI rate in patients with antimicrobial agents in the treatment protocol was 5. 81%, which was higher than those without antimicrobial agents in the treatment protocol （χ^2 = 4. 31, P〈0. 05）; NI rate in patients receiving 1,2 and 3 kinds of antimicrobial agents in the treatment protocol was 3.24%, 5.89% and 7.58% respectively. The longer duration of antimicrobial agents lasted, the higher NI rates could develop, NI rate in patients receiving antimicrobial agents for 1,2 and 3 months was 2. 95%, 5. 18% and 11.34% respectively, there was significant difference between the two respectively （both P〈0. 05）. Conclusion NI rate can increase in patients receiving antitubercular agents protocol containing antimicrobial agents.