产碳青霉烯酶肺炎克雷伯菌感染患者死亡因素分析

Influencing factors for death of patients with carbapenemase-producing Klebsiella pneumoniae infection

目的探讨产碳青霉烯酶肺炎克雷伯菌感染引起患者死亡临床影响因素。方法选取2016年8月-2017年10月医院诊治产碳青霉烯酶肺炎克雷伯菌感染患者182例临床资料行回顾性分析,根据患者治疗30天结局分为死亡组和存活组,收集两组患者一般临床资料及可疑影响因素,采用单因素和多因素Logistic回归分析引起患者死亡临床影响因素。结果单因素分析得出,年龄、合并糖尿病、合并慢阻肺、合并恶性肿瘤、感染部位、APACHEⅡ评分、机械通气、留置导尿管、重大手术、抗菌药物治疗方案在死亡组和存活组患者中比较有统计学意义(P<0.05)。多因素分析得出,年龄、感染部位、APACHEⅡ评分、抗菌药物治疗方案为影响产碳青霉烯酶肺炎克雷伯菌感染患者死亡影响因素。结论影响产碳青霉烯酶肺炎克雷伯菌感染患者死亡影响因素较多,临床中针对相关影响因素实施预防、干预对提高疗效,降低死亡率有重要意义。

OBJECTIVE To explore the influencing factors for death of the patients with carbapenemase-producing Klebsiella pneumoniae infection. METHODS A total of 182 patients with carbapenemase-producing K.pneumoniae infection who were treated in the hospital from Aug 2016 to Oct 2017 were enrolled in the study and divided into the death group and the survival group according to the 30-day treatment outcomes, the clinical data of the patients were retrospectively analyzed, the baseline data were collected from the two groups of patients, the suspected influencing factors were analyzed, and univariate analysis and multivariate logistic regression analysis were performed for the clinical influencing factors for death of the patients. RESULTS The univariate analysis showed that there were significant differences in the age, complication with diabetes mellitus, complication with chronic obstructive pulmonary disease, complication with malignant tumors, infection sites, APACHEⅡ score, mechanical ventilation, urinary catheter indwelling, major surgery and antibiotic treatment regimens between the death group and the survival group(P<0.05). The multivariate analysis indicated that the age, infection sites, APACHEⅡ score and antibiotic treatment regimens were the influencing factors for death of the patients with carbapenemase-producing K.pneumoniae infection. CONCLUSION There are a variety of influencing factors for death of the patients with carbapenemase-producing K.pneumoniae infection. It is of great significance to take prevention interventions according to the influencing factors so as to improve the curative effect and reduce the mortality rate.