某院耐碳青霉烯类肠杆菌科细菌分布特征及其易感因素分析

Distribution characteristics and susceptibility factors of carbapenem resistant enterobacteriaceae in Puyang Peoples Hospital

目的观察濮阳市人民医院耐碳青霉烯类肠杆菌科细菌(CRE)分布情况,并分析发生CRE感染的影响因素。方法前瞻性选取2019年12月至2021年12月濮阳市人民医院214例CRE感染患者作为CRE组,另选取107例非CRE感染患者作为非CRE组;CRE组患者均接受CRE细菌培养,分析CRE的分布特征及医院CRE感染危险因素。结果214例CRE感染患者共分离出CRE 300株;CRE感染患者年龄主要集中在>60岁,男性略高于女性;CRE标本主要来源于痰液,其次为尿液;CRE标本分布科室以ICU为主,其次为呼吸内科、神经外科;比较感染与未感染的CRE患者资料,并行logistics回归分析,结果显示,抗生素使用时间长、种类多、合并脑血管疾病、KPC基因型、IMP基因型、NDM基因型可能是CRE感染的危险因素(OR>1,P<0.05)。结论CRE感染患者多为老年人群,男性略高于女性,其标本主要来源于痰液,分布科室以ICU为主,可能受抗生素使用时间、种类数、合并脑血管疾病、耐药基因型的影响,应引起临床重视。

Objective To observe the distribution of carbapenem resistant enterobacteriaceae(CRE)in Puyang People's Hospital and analyze the influencing factors of CRE infection.Methods A prospective selection of 214 CRE infected patients from Puyang People's Hospital from December 2019 to December 2021 was conducted as the CRE group,and an additional 107 non CRE infected patients were selected as the non CRE group.All patients in the CRE group received CRE bacterial culture,and the distribution characteristics of CRE and risk factors for hospital CRE infection were analyzed.Results A total of 300 strains of CRE were isolated from 214 patients with CRE infection.The age of CRE infected patients was mainly concentrated in those over 60 years old,with males slightly higher than females.CRE specimens mainly came from sputum,followed by urine.CRE specimens were mainly distributed in ICU,followed by respiratory medicine and neurosurgery.The data of infected and uninfected CRE patients were compared and analyzed by logistics regression analysis.The results showed that long-term use of antibiotics,multiple types,combined cerebrovascular disease,KPC genotype,IMP genotype and NDM genotype may be risk factors for CRE infection(OR>1,P<0.05).Conclusion The majority of CRE infected patients are elderly people,with males slightly higher than females.Their specimens mainly come from sputum and are mainly distributed in ICU.They may be affected by the duration of antibiotic use,number of types,concomitant cerebrovascular diseases,and drug resistance genotypes,and should be given clinical attention.