导尿管相关尿路多重耐药菌感染影响因素分析

Analysis of influencing factors of multiple drug resistant bacteria infection in urinary catheter associated urinary tract infection

目的分析导尿管相关性尿路多重耐药菌(MDROs)感染现状与影响因素,为临床防控提供参考。方法回顾调查分析某医院导尿管相关性尿路MDROs感染情况并分析其相关影响因素。结果纳入监测的1 668例患者中,发生导尿管相关性尿路MDROs感染73例,发生率为4.38%。导尿管相关性尿路MDROs感染主要影响因素是入住ICU、留置导尿管时间长、换管次数多、采取机械通气、规范采取导尿口消毒护理、抗菌药物使用时间长、使用种数多、联用抗菌药物,其中规范导尿管口护理是保护因素,其余为危险因素。结论导尿管相关性尿路MDROs感染主要与侵入性操作、交叉感染与不合理使用抗菌药物有关,规范导尿口护理可减少MDROs感染。应严格掌握导尿指征,进行导管相关性感染目标性监测,及时评估,尽量减少不必要保留尿管,留置导尿应严格执行无菌技术,规范尿管护理,合理使用抗菌药物。

Objective To analyze the multi drug resistant bacteria catheter associated urinary tract infection（ MDROs）status and influencing factors,so as to provide reference for clinical prevention and control. Methods A retrospective investigation was done to analyze the hospital catheter associated urinary tract infection（ MDROs） and to analyze its related factors. Results Among 1 668 cases of monitoring patients,73 cases of catheter associated urinary tract infection（ MDROs） occurred,with the incidence rate of 4. 38%. The main influencing factors of catheter associated urinary tract infection（ MDROs） included the dwelling of ICU,the long time indwelling of catheter,many tube changing times,using mechanical ventilation,taking the catheterization port disinfection care normally,long time use of antibiotics,many species of using antibiotics and combined use of antimicrobial agents. The factor of taking the catheterization port disinfection care normally was the protective factor and the others were risk factors. Conclusion The catheter associated urinary tract infection（ MDROs） is related with the invasive operation,cross infection and unreasonable use of antibacterial drugs. Taking the catheterization port disinfection care normally can reduce MDROs infection. We should strictly grasp catheterization indications and catheter related infection of target monitoring,timely evaluation,minimizing unnecessary retained catheter are needed. The operating of indwelling urinary catheter should be stricly implement with aseptic technique and normalizing the urinary catheter care,rational use of antimicrobial agents are necessary standard.