耐甲氧西林金黄色葡萄球菌肺部感染相关因素分析

Related factors for pulmonary infection caused by methicillin-resistant Staphycococcus aureas

目的分析医院内耐甲氧西林金黄色葡萄球菌(MRSA)肺部感染的相关因素,提出相应的护理对策。方法采用病例对照研究模式,回顾性分析128例MRSA肺部感染患者临床资料;选取同病区,年龄、性别比例匹配的102例未感染MRSA肺炎患者作为对照;采用单因素分析法分析与MRSA肺部感染可能相关的8个因素:年龄、性别、是否是肿瘤患者、白细胞减少、血白蛋白降低混合感染、联合用药和连续使用抗菌药物时间。结果医院MRSA肺部感染率为14.1%,病死率为31.2%;单因素分析结果显示,年龄(χ2=4.561,P=0.023)、是否是肿瘤患者(χ2=8.768,P=0.002)、白细胞减少(χ2=4.304,P=0.026)、白蛋白降低(χ2=4.837,P=0.020)和混合感染(χ2=4.095,P=0.029)为MRSA肺部感染相关因素。结论积极治疗基础疾病、加强患者的营养支持、制定合理的个性化护理方案对于控制及减少MRSA肺部感染的发生具有积极意义。

OBJECTIVE To study the related factors for methicillin-resistant Staphycococcus aureas（MRSA） pulmonary infections so as to propose corresponding nursing strategy.METHODS A total of 128 patients with MRSA pulmonary infections were enrolled and retrospectively analyzed by case-control study.Other 102 patients from the same ward with matched age and sex without MRSA pulmonary infection were collected as the control group.Univariate analysis was used to analyze 8 variables that may resulted in MRSA pulmonary infections,including age,sex,tumor patients,leucopenia,lowered serum albumin,mixed infections,combination use of antibiotics,and timing for consecutive use of antibiotics.RESULTS The rate of MRSA infections was 14.1%,the mortality was 31.2%;the result of univariate analysis suggested that the age（χ2=4.561,P=0.023）,tumor（χ2=8.768,P=0.002）,leucopenia（χ2=4.304,P=0.026）,lowered blood albumin（χ2=4.837,P=0.020）and mixed infections（χ2=4.095,P=0.029）were the related factors for MRSA pulmonary infections.CONCLUSION Active treatment of primary diseases,nutrition support,and reasonable and personalized nursing strategy are effective measures to prevent MRSA pulmonary infection.