心胸外科患者多重耐药菌感染及危险因素分析

Analysis of Risk Factors Influencing Multiple Drug Resistant Organism Infection in Cardiothoracic Surgery Patients

目的探讨心胸外科住院患者多重耐药菌(MDRO)感染的特征及其危险因素。方法回顾性调查632例发生医院感染的心胸外科患者,根据其是否发生MDRO感染分为MDRO组和非MDRO组,计算MDRO感染率并分析多重耐药菌株分布,筛选影响心胸外科患者MDRO感染的相关危险因素。结果心胸外科患者MDRO感染发生率为15.19%(96/632),多重耐药菌株以鲍曼不动杆菌、金黄色葡萄球菌、铜绿假单胞菌等为主;多因素分析结果显示,影响心胸外科患者MDRO感染的危险因素包括年龄(OR=2.094)、基础疾病(OR=3.056)、机械通气(OR=4.158)、留置导管(OR=4.914)、低白蛋白血症(OR=5.197)、联合使用广谱抗菌药物(OR=3.536)、频繁更换抗菌药物(OR=4.272)等。结论心胸外科医院感染患者中具有较高的MDRO感染发生比例,影响其发生MDRO感染的危险因素较多,应尽早采取预防措施,降低MDRO感染发生率。

Objective To investigate the characteristics and risk factors of multiple drug resistant organism(MDRO)infection in hospitalized patients of cardiothoracic surgery.Methods A retrospective investigation of 632 cases of cardiothoracic surgery patients with nosocomial infection was conducted.patients were divided into MDRO group and non-MDRO group according to whether they had MDRO infection.MDRO infection rate was calculated and the distribution of multi-drug resistant strains was analyzed.The related risk factors of MDRO infection in cardiothoracic surgery patients were screened.Results The incidence of MDRO infection in cardiothoracic surgery patients was 15.19%(96/632),and the multi-drug resistant strains were mainly Acinetobacter baumannii,Staphylococcus aureus,Pseudomonas aeruginosa,etc.The results of multiple-factor analysis showed that the risk factors affecting the MDRO infection in cardiothoracic surgery included age(OR=2.094),underlying disease(OR=3.056),mechanical ventilation(OR=4.158),indwelling catheter(OR=4.914),hypoalbuminemia(OR=5.197),combining use of broad-spectrum antibacterial drugs(OR=3.536),frequent replacement of antibacterial drugs(OR=4.272),etc.Conclusion There is a high incidence of MDRO infection in patients with nosocomial infection in cardiothoracic surgery,and there are many risk factors that affect the occurrence of MDRO infection.Preventive measures should be taken as soon as possible to reduce the incidence of MDRO infection.