耐碳青霉烯类肺炎克雷伯菌感染危险因素的Meta分析

Meta analysis of risk factors for carbapenem-resistant Klebsiella pneumoniae infection

目的对耐碳青霉烯类肺炎克雷伯菌(CRKP)感染的危险因素进行系统评价。方法检索PubMed、Embase、中国知网(CNKI)等数据库从建库至2021年12月发表的有关CRKP感染危险因素相关研究文献。采用Stata 15.1软件进行Meta分析。结果共纳入27篇研究文献,Meta分析结果显示,在纳入的28项危险因素中与CRKP感染相关的危险因素有17项,分别是近期住院史、入住ICU、APACHEⅡ评分、高血压、动静脉导管、机械通气、尿导管、气管插管/切开、胃管、透析,及前期使用碳青霉烯类、头孢类、糖肽类、氨基糖苷类等抗菌药物。结论近期住院史、入住ICU、APACHEⅡ评分、高血压、有创性操作和前期使用抗菌药物是导致CRKP感染的危险因素。

Objective To systematically review the risk factors of carbapenem-resistant Klebsiella pneumoniae(CRKP)infection.Methods PubMed,Embase,China National Knowledge Infrastructure(CNKI)and other databases were retrieved from the establishment of the database to December 2021 for publications related to the risk factors of CRKP infection.Meta analysis was performed using Stata 15.1 software.Results A total of 27 studies were included.The results of Meta analysis showed that 17 of 28 risk factors were related to CRKP infection,including recent hospitalization,admission to ICU,APACHE II score,hypertension,arteriovenous catheter,mechanical ventilation,urinary catheter,endotracheal intubation/incision,gastric tube,dialysis,and previous use of carbapenems,cephalosporins,glycopeptides,aminoglycosides and other antibiotics.Conclusion Recent hospitalization,ICU admission,APACHE II score,hypertension,invasive procedures,and previous use of antibiotics are risk factors for CRKP infection.