老年期精神病患者多重耐药菌感染的危险因素分析

The risk factors of multi-resistant bacteria infection in senile psychiatric patients

目的了解老年期精神病患者多重耐药菌感染与危险因素的相关性,为临床对老年期精神病患者合理应用抗菌药物及有效控制多重耐药菌感染提供理论依据。方法收集在2012—2014年期间嘉兴市康慈医院接受治疗的年龄在60岁以上的老年期精神病患者体内分离确认的多重耐药菌株共74株,采用SPSS 17.0统计软件做多因素Logistic回归分析,分析老年期精神病患者多重耐药菌感染的相关危险因素。结果老年期精神病患者多重耐药菌感染的单因素分析显示年龄(P=0.010)、住院时间(P=0.002)、基础疾病(P=0.188)、侵入性操作(P=0.000)、抗菌药物使用(P=0.000)、抗精神病药使用(P=0.191)等均为老年期精神病患者多重耐药菌感染的相关因素。多因素Logistic回归分析显示基础疾病和侵入性操作是老年期精神病患者多重耐药菌感染的高危险因素。结论基础疾病和侵入性操作是老年期精神病患者多重耐药菌感染的高危险因素。提示临床严防抗菌药物过度应用,减少侵入性操作,从而避免老年期精神病患者感染菌株中多重耐药菌株的产生。

Objective To explore the risk factors of multi-resistant bacteria infection in senile psychiatric patients and provide clinicians with theoretical foundation for reasonable use of antimicrobial agents and effective control of the infection.Methods Seventy four multiple drug-resistant strains were isolated from senile psychiatric patients（ages over 60years）who were hospitalized from 2012 to 2014.SPSS 17.0was used to analyze the related factors with Logistic regression method.Results The age（P=0.010）,hospital stay period（P=0.002）,underlying diseases（P=0.188）,invasive operation（P=0.000）,antimicrobial agents（P=0.000）and antipsychotic drugs（P=0.191）were related to infections resulted from multi-resistant bacteria in senile psychiatric patients.Multivariable Logistic regression analysis showed that underlying diseases and invasive operation were the high-risk factors.Conclusion Underlying diseases and invasive operation were the high-risk factors for multi-resistant bacteria infections in senile psychiatric patients.Clinicians should avoid the abuse of antibacterial drugs and invasive operations to prevent infections caused by multiple drug-resistant strains in senile psychiatric patients.