慢性阻塞性肺病急性加重患者呼吸道多重耐药菌感染危险因素分析

Analysis of risk factors for lower respiratory tract infections caused by multi-drug resistant bacterial in AECOPD patients

目的分析慢性阻塞性肺疾病急性加重(AECOPD)患者呼吸道多重耐药菌感染的危险因素,为防控COPD提供依据。方法选取2015年1月-2017年3月医院收治的AECOPD合并呼吸道细菌感染患者78例作为研究对象,分析多重耐药菌感染率,并采用单因素及多因素logistic回归方法对AECOPD合并呼吸道多重耐药菌感染的危险因素进行分析。结果 AECOPD患者肺部多重耐药菌感染率为14.10%。单因素分析结果显示,呼吸衰竭、既往一年因COPD入院次数、呼吸疾病史,对AECOPD合并呼吸道多重耐药菌感染的影响有统计学意义(P<0.05);多因素logistic回归分析结果显示,呼吸衰竭、既往一年因COPD入院次数是导致AECOPD合并呼吸道多重耐药菌感染的独立危险因素(P<0.05)。结论 AECOPD合并肺部感染中,多重耐药菌感染比例较高。呼吸衰竭、既往一年因COPD入院次数,是AECOPD合并多重耐药菌感染的独立危险因素,及早控制这些危险因素可以降低AECOPD患者合并多重耐药菌感染。

Objective To explore the risk factors for lower respiratory tract infections caused by multidrug-resistant bacterial(MDRB)in AECOPD patients and to provide scientific evidence for prevention and control of COPD.Methods 78 AECOPD patients with lower respiratory tract infection were selected from January 2015 to March 2017,the incidence of MDRB infection was observed,and then the univariate analysis and the multivariate logistic regression analysis were performed to analyze the risk factors for MDRB infection in the AECOPD patients.Results The incidence of MDRB infection was 14.10%.Univariate analysis showed that the influences of respiratory disease history,number of hospitalizations in the past year,and respiratory failure on pulmonary MDRB infection in patients with AECOPD were statistically significant(P<0.05).The multivariate logistic regression analysis indicated that number of hospitalizations in the past year and respiratory failure were the independent risk factors for pulmonary MDRB infection in patients with AECOPD(P<0.05).Conclusion In AECOPD patients combined with pulmonary infection,the detection rate of multidrug-resistant bacteria is large.The number of hospitalizations in the past year and respiratory failure are the independent risk factors for pulmonary MDRB infection in patients with AECOPD.Early prevention and control of these risk factors can reduce MDRB infection in AECOPD patients.