重症监护室患者耐碳青霉烯类肠杆菌感染情况及危险因素分析

Infection and risk factors of carbapenem resistant Enterobacteriaceae in patients in intensive care unit

目的分析重症监护病房(ICU)患者耐碳青霉烯类肠杆菌(CRE)感染情况及其危险因素。方法抽取2018年5月至2020年5月聊城市人民医院ICU收治的118例患者作为研究对象, 将其中ICU住院期间感染CRE者纳入感染组, 未感染CRE者纳入未感染组。比较两组患者的临床资料, 分析ICU患者感染CRE的情况及其危险因素。结果 118例ICU住院患者中, 36例发生CRE感染, 感染率为30.51%, 纳入感染组;余82例患者纳入未感染组。感染组手术治疗、频繁使用抗生素、机械通气时间及血清免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平与未感染组比较, 差异有统计学意义(P<0.05)。Logistic回归分析结果显示, 手术治疗、频繁使用抗生素、机械通气时间长及血清IgA、IgG、IgM水平低是ICU患者CRE感染的危险因素(OR均>1, P均<0.05)。结论 ICU患者CRE感染风险较高, 手术治疗、频繁使用抗生素、机械通气时间长及血清IgA、IgG、IgM水平低是ICU患者CRE感染的危险因素。

Objective To analyze the condition and risk factors of carbapenem resistant Enterobacteriaceae(CRE)infection in patients in intensive care unit(ICU).Methods One hundred and eighteen patients admitted to the ICU of Liaocheng People’s Hospital from May 2018 to May 2020 were selected as the research objects.Among them,the patients with CRE infection during ICU hospitalization were included in the infected group,and patients without CRE during the same period were included in the uninfected group.The clinical data of the two groups were compared,and the situation and risk factors for CRE infection in ICU patients were analyzed.Results Among the 118 ICU inpatients,36 patients had CRE infection,the infection rate was 30.51%,and they were included into the infected group;the other 82 cases were included into the uninfected group.There were significant differences in surgical treatment,frequency of antibiotics,mechanical ventilation time and the levels of serum immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)between the infected group and the uninfected group(P<0.05).Results of Logistic regression analysis showed that surgical treatment,frequency of antibiotics,long mechanical ventilation time and low levels of serum IgA,IgG and IgM were the risk factors for CRE infection in ICU patients(all OR>1,all P<0.05).Conclusions ICU patients have a high risk of CRE infection,and the risk factors for CRE infection includes surgical treatment,frequency of antibiotics,long mechanical ventilation time and low levels of serum IgA,IgG and IgM.