耐碳青霉烯类肠杆菌科细菌的感染特征和危险因素分析

Infection characteristics and risk factors of carbapenem resistant Enterobacteriaceae

目的研究耐碳青霉烯类肠杆菌科细菌(CRE)的感染特征和危险因素。方法将50例CRE感染患者设为研究组,同期50例未感染肺炎克雷伯菌或大肠埃希菌的患者设为对照组,分析CRE的感染特征和危险因素。结果CRE的常见感染部位为呼吸道(40.00%),常见感染科室为重症医学科(32.00%)及呼吸重症监护室(28.00%)。单因素分析结果显示,研究组患者的多药联用、真菌类、万古霉素类、氨基糖苷类、广谱青霉素、头孢菌素类、感染前抗菌药物使用、导尿管、气管插管、危重症监护室入住占比分别为68.00%、40.00%、30.00%、16.00%、42.00%、52.00%、76.00%、28.00%、78.00%、54.00%,均高于对照组的24.00%、6.00%、2.00%、2.00%、6.00%、26.00%、38.00%、6.00%、28.00%、28.00%,差异均具有统计学意义(P<0.05)。多因素分析显示,感染前抗菌药物使用、气管插管是CRE感染的独立危险因素(P<0.05)。结论CRE感染的易感人群是重症患者,呼吸道是常见感染部位,感染前抗菌药物使用、气管插管是独立危险因素。

Objective To study the infection characteristics and risk factors of carbapenem resistant Enterobacteriaceae(CRE).Methods There were 50 patients with CRE infection set as the research group,and 50 patients without Klebsiella pneumonia or Escherichia coli as the control group during the same period,and the infection characteristics and risk factors of CRE were analyzed.Results The common infection site of CRE was the respiratory tract(40.00%),and the common infection departments were the intensive care unit(32.00%)and the respiratory intensive care unit(28.00%).Univariate analysis showed that proportion of multi-drug combination,fungi,vancomycin,aminoglycosides,broad-spectrum penicillin,cephalosporins,use of antibiotics before infection,catheterization,tracheal cannula and ICU occupancy in the research group were 68.00%,40.00%,30.00%,16.00%,42.00%,52.00%,76.00%,28.00%,78.00%,54.00%,respectively,which were all higher than 24.00%,6.00%,2.00%,2.00%,6.00%,26.00%,38.00%,6.00%,28.00%,28.00%of the control group,and the differences were statistically significant(P<0.05).Multivariate analysis showed that use of antibiotics before infection and tracheal cannula were independent risk factors for CRE infection(P<0.05).Conclusion The susceptible population of CRE infection is severely ill patients,the respiratory tract is a common site of infection,and the use of antibacterial drugs before infection and tracheal cannula are independent risk factors.