老年住院患者感染耐碳青霉烯肠杆菌科细菌的耐药性和危险因素分析

Analysis of drug resistance and risk factors of carbapenem-resistant Enterobacteriaceae infections in elderly inpatients

目的分析老年住院患者感染耐碳青霉烯类肠杆菌科细菌(CRE)的耐药情况以及危险因素,为预防CRE的感染提供理论依据。方法收集2015年1月—2018年12月老年科感染CRE的62例住院患者作为病例组,回顾性分析患者分离菌株的耐药性、人口学信息、临床资料,将同期入院感染碳青霉烯类敏感肠杆菌科(CSE)62例患者作为对照组,对老年患者感染CRE的危险因素进行单因素及多因素Logistic回归分析。结果老年患者感染的CRE菌株对β-内酰胺类抗菌药物、氟喹诺酮类抗菌药物耐药率均在88%以上。留置导管、留置胃管、呼吸道疾病是老年患者感染CRE的独立危险因素。结论老年患者感染的CRE菌株耐药性比较严重,临床应重视呼吸道感染的防控,减少不必要的侵袭操作。

Objective To analyze the drug resistance profiles of elderly inpatients infected with carbapenemresistant Enterobacteriaceae(CRE) and to explore the risk factors of CRE infections from elderly patients, and to provide a theoretical basis for the prevention of CRE infections. Methods From January 2015 to December 2018, 62 inpatients with CRE infections from the geriatric inpatients were chosen as a case group. The drug resistance, demographic information, and clinical data were collected. During the same period, 62 patients with carbapenemsensitive Enterobacteriaceae(CSE) infections from the same ward were set as a control group, and the risk factors of CRE infections from elderly patients were analyzed by the univariate and multivariate logistic regression analysis. Results The resistance rates of CRE strains in the infected elderly patients to β-lactam antibiotics and fluoroquinolones were above 88%. Indwelling catheter, indwelling gastric tube, and respiratory diseases were independent risk factors for the CRE infections in elderly patients. Conclusion CRE strains in infected elderly patients have serious drug resistance. In clinical practice, attentions should be paid to the prevention and control of respiratory infections and reducing unnecessary invasion operations.