ICU患者多重耐药菌的感染特点及相关危险因素的分析

目的：探讨重症监护病房（ICU）多重耐药菌的分布特点以及多重耐药菌感染的危险因素.方法：采用回顾性分析的方法,对2015年从ICU患者身上分离病原菌进行分析;同时在非多重耐药和多重耐药组患者之间进行多重耐药菌危险因素分析.结果：分离出的198株病原菌中多重耐药菌97株（48.99%）;其中,MDR-Ab35株（36.1%）、MDR-PA17株（17.52%）、ESBLs-Eco16株（16.49%）、ESBLs-Kpn15株（15.46%）、MRSA14株（14.43%）;多因素logistics回归分析显示住院时间、留置导尿时间、留置胃管时间、使用三种以上抗生素、应用碳青霉烯类抗生素、有创机械通气时间为多重耐药菌感染的独立危险因素.结论：ICU多重耐药菌感染发生率高;患者住院时间、留置导尿时间、留置胃管时间、使用三种以上抗生素、应用碳青霉烯类抗生素、有创机械通气时间与患者发生多重耐药菌感染有密切关系.

Objective： To investigate the distributionof multi drug resistant bacteria in intensive care unit （ICU）, and the risk factors of multi drug resistant bacteria infection. Methods： A retrospective analysis was conducted to analyze the pathogenic bacteria isolated from ICU patients in 2015. Risk factors for multi drug resistant bacteria in patients with non multidrug resistance and multi drug resistant groups. Results： Isolated 198 strains of pathogenic bacteria and multi drug resistant bacteria 97 strains （48.99%）; among them, MDR-AB 35 strains （36.1%）, MDR-PA17 strains （17.52%）, ESBLs-Eco16 strains （16.49%）, ESBLs-Kpn15 strains （15.46%）, MRSA14 strains （14.43%）; multiple logistic regression analysis showed that the hospitalization time, indwelling catheter time, time of indwelling gastric tube, the use of more than three kinds of antibiotics, application of carbapenem antibiotics, invasive mechanical ventilation time for multi drug resistant bacteria infection is an independent risk factor. Conclusion： The prevalence rate of ICU multi drug resistant bacteria is high. Hospitalization time, indwelling catheter time, time of indwelling gastric tube, the use of more than three kinds of antibiotics, application of carbapenem antibiotics, invasive mechanical ventilation time and patient occurrence of multi drug resistant bacteria infection has close relationship.