首页|老年患者导管相关性尿路多重耐药菌感染危险因素及其预测模型

老年患者导管相关性尿路多重耐药菌感染危险因素及其预测模型

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目的 研究导尿管相关尿路感染(CAUTI)老年患者多重耐药菌(MDRO)感染情况并分析感染因素。方法 选取江苏省人民医院2021年1月至2022年7月收治的175例CAUTI老年患者的病历资料，统计CAUTI老年患者MDRO感染分布情况，分析相关MDRO感染的影响因素。通过受试者工作特征(ROC)曲线分析独立危险因素对相关医院感染的预测价值。结果 175例CAUTI老年患者中，87例(49。71％)发生MDRO感染(纳入MDRO感染组)，88例(50。29％)未发生MDRO感染(纳入非MDRO感染组)。MDRO感染组检出MDRO病原菌432株，其中革兰氏阴性菌415株(96。06％)，主要为耐碳青霉烯类鲍曼不动杆菌186株(43。06％)，耐碳青霉烯类肺炎克雷伯菌147株(34。03％)，耐碳青霉烯类铜绿假单胞菌79株(18。29％)及耐青耐碳青霉烯类大肠埃希菌3株(0。69％);革兰氏阳性菌17株(3。94％)，均为耐甲氧西林金黄色葡萄球菌。多因素分析结果显示，使用碳青霉烯类、替加环素、多黏菌素，以及中心静脉插管时间长为独立危险因素，采用这4项自变量对CAUTI老年患者MDRO感染风险进行预测，ROC曲线下面积为0。883。结论 针对CAUTI老年患者，要采取严格的抗菌药物管理措施，掌握抗菌药物的应用指征，缩短患者住院时间，降低MDRO感染发生率。
Risk factors and prediction model of catheter-associated urinary tract multidrug resistant bacterial infection in elderly patients
Objective To study the infection of multidrug-resistant organism(MDRO)in elderly pa-tients with catheter-associated urinary tract infection(CAUTI)and analyze the infection factors.Methods The medi-cal records of 175 elderly patients with CAUTI admitted to Jiangsu Province Hospital from January 2021 to July 2022 were selected,the distribution of MDRO infection in elderly patients with CAUTI was analyzed,and the influencing factors of MDRO infection were analyzed.The predictive value of independent risk factors for rele-vant nosocomial infections was analyzed by receiver operating characteristics(ROC)curves.Results Among the 175 elderly patients with CAUTI,87 cases(49.71％)developed MDRO infection and were included in the MDRO infection group),and 88 cases(50.29％)had no MDRO infection and were included in the non-MDRO infection group.A total of 432 MDRO pathogens were detected in the MDRO infection group,inclu-ding 415 strains of Gram-negative bacteria,accounting for 96.06％,186 strains of carbapenem-resistant Acine-tobacter baumannii(43.06％),147 strains of carbapenem-resistant Klebsiella pneumoniae(34.03％),79 strains of carbapenem-resistant Pseudomonas aeruginosa(18.29％)and 3 strains of carbapenem-resistant Escherichia coli(0.69％).There were 17 strains of Gram-positive bacteria(3.94％),all of which were methi-cillin-resistant Staphylococcus aureus.Multivariate analysis showed that the use of carbapenems,tigecycline,polymyxin,and days of central venous intubation were considered as independent risk factors.The area under the curve of MDRO infection was 0.883.Conclusion For elderly patients with CAUTI,it is necessary to take strict antimicrobial management measures,master the indications of antimicrobial application,shorten the hos-pitalization time of patients and reduce the incidence of MDRO infection.

elderlymulti-drug resistant bacteriacatheter-associated urinary tract infectionrisk factors

刘娟、张小霞、臧凤、李松琴、李占结、崔婷、王科、赖晓莹、张东芳

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江苏省人民医院/南京医科大学第一附属医院感染管理处,南京 210029

同济大学附属上海市第四人民医院感控管理办公室,上海 200081

同济大学附属上海市第四人民医院医务部,上海 200081

上海市虹口区江湾医院科教科,上海 200081

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老年 多重耐药菌 导管相关性尿路感染 危险因素

国家重点研发计划中国老年医学学会感染防控研究基金江苏省医院协会医院管理创新研究项目江苏省医院协会医院管理创新研究项目江苏省人民医院优秀中青年人才培养项目(第三期)南京医科大学第一附属医院青年基金培育计划

2020YFC0848100GRYJ-LRK2018016JSYGY-3-2020-692JSYGY-3-2019-48YNRCQN0314PY2022017

2024

10.3969/j.issn.1671-8348.2024.10.014

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子：1.797
ISSN：1671-8348
年,卷(期)：2024.53(10)
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