耐碳青霉烯类克雷伯菌肺炎相关危险因素临床分析

Clinical analysis of risk factors related to pneumonia of carbapenem-resistant Klebsiella pneumoniae

目的探讨耐碳青霉烯类克雷伯菌肺炎(CRKP)相关危险因素,为临床有效防治CRKP提供依据。方法选择2017年05月至2021年09月郑州市第一人民医院呼吸与危重症医学科收治的CRKP患者48例,同期非CRKP 48例。对可能与CRKP有关的20个因素进行单因素分析,把单因素分析中存在显著差异的变量作为自变量,进行Logistic回归分析,确定CRKP的独立危险因素。结果Logistic回归分析显示CRKP的危险因素有:年龄≥65岁、糖尿病、入住重症监护室、气管插管、机械通气、吸痰、糖皮质激素应用、抗菌药物暴露(碳青霉烯类、β-内酰胺类、喹诺酮类抗菌药物应用)(P<0.05)。结论患者年龄≥65岁、糖尿病、入住重症监护室、气管插管、机械通气、吸痰、糖皮质激素应用及碳青霉烯类、β-内酰胺类、喹诺酮类抗菌药物暴露可能是CRKP的独立危险因素。

Objective To investigate the risk factors of carbapenem-resistant Klebsiella pneumoniae(CRKP)pneumonia,in order to provide evidence for effective prevention and treatment of CRKP pneumonia.Methods 48 cases of CRKP pneumonia and 48 cases of non-CRKP pneumonia were selected from May 2017 to September 2021 in Zhengzhou First People′s Hospital.Univariate analysis was used to analyze 20 factors which might be related to CRKP pneumonia.Logistic regression analysis was used to identify the independent risk factors of CRKP pneumonia.Results Logistic regression analysis showed that the risk factors of CRKP pneumonia were:age≥65 years,diabetes,intensive-care unit,tracheal intubation,mechanical ventilation,sputum aspiration,glucocorticoid application,and antibiotic exposure(carbapenem,β-Lactam,quinolone)(P<0.05).Conclusion Age≥65 years,diabetes,intensive-care unit,tracheal intubation,mechanical ventilation,sputum aspiration,glucocorticoid application,and carbapenem,β-Lactam,quinolone antibiotic exposure may be independent risk factors for CRKP pneumonia.