医院感染产ESBLs大肠埃希菌危险因素分析

Risk factors of nosocomial infections with ESBLs-producing Escherichia coli

目的分析某三级甲等医院产超广谱β-内酰胺酶(ESBLs)大肠埃希菌医院感染的现状及危险因素,为预防和控制该菌的医院感染提供参考依据。方法回顾性研究2013年1月1日-2015年12月31日检出大肠埃希菌病例848例,分析产ESBLs大肠埃希菌感染因素,采用单因素及多因素logistic回归分析。结果共调查848例检出大肠埃希菌医院感染病例,其中527例为产ESBLs大肠埃希菌感染,感染率为62.15%;多因素logistic回归分析结果显示:使用第三代头孢菌素、尿管插管、抗菌药物联用、年龄及住院天数是其感染的危险因素(P<0.05);趋势χ~2分析发现随着年龄的增大,发生产ESBLs的大肠埃希菌医院感染的风险高。结论加强重点人群监测,合理使用抗菌药物,有利于预防和控制该菌的医院感染。

OBJECTIVE To To investigate the current situation and risk factors of nosocomial infections with ESBLs-producing Escherichia coli in a gradeⅢ,class A hospital,so as to provide the basis for preventing and controlling nosocomial infections.METHODS A total of 848 cases of patients with Escherichia coli from 2013 to 2015were retrospectively analyzed.The risk factors of infection with ESBLs-producing E.coli were analyzed,and univariate and multivariable logistic regression analysis were carried out.RESULTS Totally 848 cases of nosocomial infections with E.coli were investigated,of which 527 cases were infections with ESBLs-producing E.coli,and the infection rate was 62.15% .The multivariable logistic regression analysis showed that,the use of the third-generation of cephalosporins,catheter indwelling,the combined use of antibiotics,age and hospitalization days were risk factors for infections（P〈0.05）.Trend χ2 analysis showed that with the increase of age,the risk of nosocomial infections of ESBLs-producing E.coli was high.CONCLUSION We should be ready for the monitoring of the vulnerable groups,rational use of antibiotics,so as to prevent and control the ESBLs-producing E.coliinfections.