维持性血液透析患者发生CRBSI的病原菌耐药情况分析

Analysis of drug resistance of pathogenic bacteria in maintenance hemodialysis patients with CRBSI

目的:探讨维持性血液透析(MHD)的尿毒症患者发生导管相关性血流感染(CRBSI)的病原菌、耐药情况分析。方法:选取MHD治疗的211例尿毒症患者,根据其是否发生CRBSI分为CRBSI组50例、未发生CRBSI的患者161例(对照组);统计分析CRBSI组的病原菌分布及耐药情况;采用Logistic回归模型分析MHD治疗的尿毒症患者发生CRBSI的相关因素。结果:CRBSI组50例患者共计培养出革兰阳性菌25株(50.00%)、革兰阴性菌25株(50.00%);采用非条件Logistic回归分析显示:原发疾病为糖尿病肾病、伴有皮肤感染是MHD患者发生CRBSI的独立危险因素(P<0.05),使用抗菌药物、Hb水平升高是MHD患者发生CRBSI的独立保护因素(P<0.05)。结论:MHD患者发生CRBSI的病原菌以革兰阳性菌为主、耐药率较高,应该针对发生CRBSI的危险因素予以预防措施处理。

Objective:To investigate the pathogenic bacteria and drug resistance of uremic patients with maintenance hemodialysis(MHD)with catheter-related blood flow infection(CRBSI).Methods:Using retrospective research methods,211 uremic patients treated with MHD were selected and divided into 50 cases of CRBSI group and 161 cases of non-CRBSI group(control group)according to whether CRBSI occurred.Statistical analysis of the distribution of pathogenic bacteria and drug resistance in the CRBSI group;Logistic regression model was used to analyze the related factors of CRBSI in uremia patients treated with MHD.Results:A total of 50 patients in the CRBSI group cultured 25 strains of Gram-positive bacteria(50.00%)and 25 strains of Gram-negative bacteria(50.00%);the results of unconditional logistic regression analysis showed:the primary disease is diabetic nephropathy,accompanied by skin infection is an independent risk factor for CRBSI in patients with MHD(P<0.05).The use of antibacterial drugs and elevated Hb levels are independent protective factors for CRBSI in MHD patients(P<0.05).Conclusion:The pathogenic bacteria of CRBSI in MHD patients are mainly Gram-positive bacteria,and the drug resistance rate is high.Preventive measures should be taken for the risk factors of CRBSI.