医院多重耐药菌血流感染相关因素Logistic回归分析

Logistic regression analysis of related factors of bloodstream infection of multidrug resistant organism in hospital

目的探讨医院多重耐药菌(MDRO)血流感染特点与相关因素,为临床提供依据。方法回顾2014年1月-2018年5月487例医院血流感染患者临床资料,采用SPSS 19. 0软件进行统计分析。结果医院MDRO血流感染率为19. 71%;单因素分析得知患者糖尿病史、感染前住院时间≥7 d、入住ICU、APACHEⅡ评分≥20、手术治疗、深静脉置管、机械通气、留置导尿、使用糖皮质激素、抗菌药物使用时间≥7 d、抗菌药物种数≥3种、联用抗菌药物≥3种、血糖>11. 1 mmol/L、血清白蛋白<30 g/L等14个因素是医院MDRO血流感染的危险因素(P <0. 05);多因素分析得知患者入住ICU、机械通气、深静脉置管、留置导尿、联用抗菌药物≥3种、抗菌药物使用时间≥7 d等6个因素是医院MDRO血流感染的独立危险因素(P <0. 05)。结论正确合理使用抗菌药物,减少不必要的侵入性诊疗操作,缩短入住ICU时间,加强ICU医院MDRO防控是降低医院MDRO血流感染的主要措施。

Objective To investigate the characteristics and related factors of bloodstream infection of multidrug resistant organism(MDRO)in hospital and provide evidence for clinical practice.Methods The clinical data of 487 patients with nosocomial bloodstream infection from January 2014 to May 2018 were retrospectively analyzed by SPSS 19.0 software package.Results The bloodstream infection rate of MDRO in hospital was 19.71%.Univariate analysis showed that 14 factors such as the history of diabetes mellitus,hospitalization time before infection≥7 d,ICU admission,APACHE II score≥20,surgical treatment,deep venous catheterization,mechanical ventilation,indwelling catheterization,use of glucocorticoids,duration of use of antibiotics≥7 d,number of antibiotics≥3,combined use of antibiotics≥3,blood glucose>11.1 mmol/L and serum albumin<30 g/L were risk factors for MDRO bloodstream infection in hospital(P<0.05).Multivariate analysis showed that 6 factors such as ICU admission,mechanical ventilation,deep venous catheterization,indwelling catheterization,combined use of antibiotics≥3 and duration of use of antibiotics≥7 d were independent risk factors for MDRO bloodstream infection in hospital(P<0.05).Conclusion Correct and rational use of antibiotics,reduction of unnecessary invasive diagnosis and treatment operations,shortening of ICU admission time,and strengthening the prevention and control of MDRO in hospital ICU are the main measures to reduce hospital MDRO bloodstream infection.