呼吸重症监护室患者感染耐碳青霉烯类肺炎克雷伯菌和死亡危险因素分析

Risk Factor Analysis of Carbapenem-Resistant Klebsiella Pneumoniae Infection and Mortality in Respiratory Intensive Care Unit Patients

目的探究呼吸重症监护室患者感染耐碳青霉烯类肺炎克雷伯菌(carbapenem-resistant klebsiella pneumoniae,CRKP)的感染和死亡危险因素。方法选择某三甲医院2021年10月至2022年4月呼吸重症监护室住院患者93例,分为CRKP组43例和对照组50例,根据出院情况将CRKP组分为生存组12例和死亡组31例进一步分析。将对照研究中有意义的因素纳入Logistic回归模型进行多因素分析,探究CRKP感染危险因素和死亡危险因素。结果性别、慢性肾脏疾病、中心静脉置管时间、机械通气时间、留置导尿管时间、谷丙转氨酶(alanine transaminase,ALT)、白介素-6(interleukin-6,IL-6)和C反应蛋白(c-reactive protein,CRP)均与CRKP感染相关(P<0.05);CRP、IL-6和脓毒血症与CRKP感染后死亡相关(P<0.05)。多因素分析结果显示,机械通气时间、ALT是CRKP感染的独立危险因素;脓毒血症是CRKP感染后死亡的独立危险因素。结论CRKP感染患者死亡率较高;正确识别CRKP感染的独立危险因素,有助于CRKP的管理,进而降低患者死亡率。

Objective To investigate the Risk Factors for Infection and Mortality Associated with Carbapenem-Resistant Klebsi-ella Pneumoniae(CRKP)in Patients in the Respiratory Intensive Care Unit.Methods A total of 93 hospitalized patients in the respira-tory ICU of a tertiary hospital from October 2021 to April 2022 were selected.They were divided into CRKP group(43 patients)and control group(50 patients).The CRKP group was further stratified into survival subgroup(12 patients)and mortality subgroup(31 pa-tients)for further analysis.Factors of significance in the control study were included in a Logistic regression model for multifactorial analysis to explore the risk factors for CRKP infection and mortality.Results The results indicated that gender,chronic kidney disease,duration of central venous catheter placement,mechanical ventilation time,indwelling urinary catheter time,Alanine transaminase(ALT),Interleukin-6(IL-6),and C-reactive protein(CRP)were all associated with CRKP infection(P<0.05);CRP,IL-6,and sepsis were correlated with mortality following CRKP infection(P<0.05).Multivariate analysis revealed that mechanical ventilation time and ALT were independent risk factors for CRKP infection;sepsis was an independent risk factor for mortality post CRKP infec-tion.Conclusion The mortality rate in patients with CRKP infection was high.Correctly identifying the independent risk factors for CRKP infection could aid in the management of CRKP and reduce patient mortality.