耐碳青霉烯类肠杆菌科细菌耐药的临床危险因素分析

Analysis of clinical risk factors for bacterial resistance to carbapenem-resistant Enterobacteriaceae

目的:分析重症监护病房(ICU)中耐碳青霉烯类肠杆菌科细菌(CRE)发生耐药的临床危险因素,为临床降低肠杆菌科细菌耐药性提供依据。方法:统计本院2018年5月—2019年6月180例ICU住院患者(其中CRE感染组60例,非CRE感染组120例)的基本病史、基础疾病、免疫功能、抗生素暴露、侵入性手术等资料,应用SPSS16.0软件对数据进行分析。结果:入住ICU时间>7 d、伴有神经系统疾病、淋巴细胞减少、使用β-内酰胺酶抑制剂、使用碳青霉烯类抗生素、抗生素联合用药等因素与CRE耐药的发生有关。结论:入住ICU时间>7 d、淋巴细胞减少、使用β-内酰胺酶抑制剂和使用碳青霉烯类抗生素是发生CRE耐药的独立临床危险因素。

Objective:To analyze the clinical risk factors for bacterial resistance to carbapenem-resistant Enterobacteriaceae(CRE)in intensive care unit(ICU),and provide the basis for reduction of Enterobacteriaceae bacterial resistance.Methods:The basic medical history,basic diseases,immune function,antibiotic exposure,invasive surgery and other data of 180 ICU inpatients in our hospital from May 2018 to June 2019(60 in CRE infection group and 120 in non-CRE infection group)were analyzed by SPSS16.0 software.Results:The ICU occupancy time>7 days,with neurological diseases,lymphopenia,use ofβ-lactamase inhibitors,use of carbapenem antibiotics and combination of antibiotics were related to the occurrence of CRE resistance.Conclusions:The ICU occupancy time>7 d,lymphopenia,use ofβ-lactamase inhibitors,and use of carbapenem antibiotics are the independent clinical risk factors for developing CRE resistance.