重症监护室患者多重耐药菌感染影响因素的Meta分析

Meta-analysis of influencing factors of multi drug resistant bacteria infection in intensive care unit

目的探讨长期抗病毒治疗治疗(antiretroviral therapy,ART)的人类免疫缺陷病毒系统评价重症监护室(intensive care unit,ICU)患者多重耐药菌(multi drug resistant organisms,MDRO)感染的影响因素。方法以建库至2024年7月为检索时限,计算机检索Ovid、Pub Med、CNKI、Embase、Wan Fang等主要数据库中有关ICU患者MDRO感染的队列研究或病例对照研究,经文献筛选、评价及提取有效数据后,以Rev Man5.3软件行统计分析。结果纳入研究23项,ICU患者共11933例。Meta分析结果显示,感染组与非感染组比较,患者入住ICU天数MD=5.05,z=5.710,P=0.000;住院天数MD=12.62,z=9.160,P=0.000;急性生理及慢性健康评估(acute physiology and chronic health evaluation,APACHE)评分MD=1.78,z=5.820,P=0.000;静脉置管OR=3.600,z=4.570,P=0.000;抗菌药物联用OR=5.540,z=15.330,P=0.000。结论患者入住ICU天数、住院天数、APACHE评分、静脉置管、抗菌药物联用是ICU患者MDRO感染的影响因素,临床需予以重视。

Objective To systematically evaluate the factors affecting infection with multi-drug resistant organisms(MDRO)in an intensive care unit(ICU).Methods Case-control or cohort studies on MDRO infection in ICU patients were retrieved from Ovid,PubMed,CNKI,Embase,WanFang,and other major databases with the retrieval time from July 2024.After screening the literature,evaluating it,and extracting valid data,statistical analysis was performed using RevMan5.3 software.Results A total of 11933 ICU patients were included in 23 studies.The results of meta-analysis showed that ICU days MD=5.05,z=5.710,P=0.000.Days of hospitalization MD=12.62,z=9.160,P=0.000.Acute physiological and chronic health evaluation(APACHE)score MD=1.78,z=5.820,P=0.000.Surgery OR=1.390,z=1.410,P=0.16.Intravenous catheterization OR=3.600,z=4.570,P=0.000.Combination of antibiotics OR=5.540,z=15.330,P=0.000.Conclusion ICU days,length of stay,APACHE score,intravenous catheterization,and combination of antibiotics are the factors influencing MDRO infection in ICU patients,and these should be paid clinical attention to.