多重耐药细菌感染相关危险因素的病例对照研究

Case-Control Study of Risk Factor for Multidrug-Resistant Bacterial Infections

目的探讨多重耐药细菌感染临床相关危险因素,为采取有针对性的预防措施提供循证医学依据。方法采用回顾性病例对照研究方法,选择2008年至2010年本院住院期间感染多重耐药菌的骨伤科住院病例100例作为阳性病例,选择与阳性病例住院时间、临床诊断、患者情况、主管医生或手术医生、手术名称等基础情况相同或接近的非多重耐药菌感染病例100例作为阴性对照病例,对两组病例的观察指标分别进行Logistic单因素和多因素回归分析,筛选多重耐药菌感染的相关危险因素。结果按OR值由大到小排列,每次抗菌药物剂量过小、每天给药次数过少、抗菌药物品种选择不正确依次为多重耐药菌感染的危险因素。结论需重视抗菌药物的规范使用,特别是每次给药剂量、每天给药次数、抗菌药物品种选择要正确,防止多重耐药菌感染。

Objective To study clinical risk factors of multidrug-resistant bacterial infections and to provide evidence-based support for specific preventive interventions.Methods By the method of retrospective case-control,100 cases of multidrug-resistant bacterial infections in orthopaedic trauma department from 2008~2010 was selected as positive group;100 cases without multidrug-resistant bacterial infections were selected as negative group,of which hospital stays,clinical diagnosis,case situation,doctors in charge,surgeon and name of operation all the same or similar to the positive group.Data of those 2 groups was analyzed by single logistic regression and multi-factor logistic regression,so as to filter the risk factors.Results Ranged by value of OR,according to priority,deficient doses of antibiotic,not enough frequency of administration and incorrect choice for antibiotics were the risk factors.Conclusion On the prevention of multidrug-resistant bacterial infections,specific and correct application of antibiotic is needed,especially in the doses and frequency of administration,choice of antibiotic.