重症监护病房车祸伤患者并发多重耐药菌感染的影响因素

Risk factors of multidrug-resistant organism infection in patients with car accident injuries in intensive care unit

目的 探讨重症监护病房(intensive care unit, ICU)车祸伤患者感染多重耐药菌(multidrugresistant organism, MDRO)的相关危险因素,为减少车祸伤患者发生MDRO感染提供临床指导。方法 收集2019年1月1日—2023年2月28日四川省人民医院入住ICU的车祸伤患者的临床资料,回顾性分析相关数据,探讨MDRO感染发生的危险因素。结果 共收集141例入住ICU的车祸伤患者,其中有30例发生MDRO感染。感染组中男性患者占比(P=0.012)、留置导尿管(P=0.005)、机械通气(P=0.001)、住院天数(P<0.001)及治疗总费用(P<0.001)均高于非感染组。多因素logistic回归分析显示男性[比值比(odds ratio, OR)=3.797,95%置信区间(confidence interval, CI)(1.174,12.275),P=0.026]、机械通气[OR=4.596,95%CI(1.538,13.734),P=0.006]和住院天数≥20 d[OR=1.014,95%CI(1.001,1.028),P=0.037]是车祸伤患者并发MDRO感染的独立危险因素。结论 男性、机械通气和住院时长增加是车祸伤患者并发MDRO感染的独立危险因素,对这类患者应严格落实医院感染预防和控制措施,以减少感染风险。

Objective To investigate the risk factors of multidrug-resistant organism(MDRO)infection in patients with car accident injuries in intensive care unit(ICU),providing clinical guidance for reducing MDRO infection in car accident patients.Methods The clinical data of patients with car accident injuries in Sichuan Provincial People’s Hospital between January 1st 2019 and February 28th 2023 were collected,and the relevant data were analyzed retrospectively to explore the risk factors of MDRO infection.Results A total of 141 patients with car accident injuries were collected,of whom 30 had MDRO infection.The proportions of males(P=0.012),indwelling catheters(P=0.005),mechanical ventilation(P=0.001),length of hospital stay(P<0.001),and total treatment costs(P<0.001)in the infection group were higher than those in the non-infection group.Multiple logistic regression analysis showed that male[odds ratio(OR)=3.797,95%confidence interval(CI)(1.174,12.275),P=0.026],mechanical ventilation[OR=4.596,95%CI(1.538,13.734),P=0.006],and length of hospital stay≥20 d[OR=1.014,95%CI(1.001,1.028),P=0.037]were independent risk factors for MDRO infection in car accident patients.Conclusions Male,mechanical ventilation,and increased length of hospital stay are independent risk factors for MDRO infection in car accident patients.For such patients,the prevention and control measures of hospital infection should be strictly implemented to reduce the risk of infection.