常州市某医院＞60岁肺部感染者多重耐药菌病原学特征及危险因素分析
Etiological characteristics and risk factors of multidrug-resistant organisms among the elderly with pulmonary infections and at ages of over 60 years in a hospital in Changzhou City
唐维君 1史志勇 1瞿云 1丁丽 2秦立强 3杨妍华1
作者信息
- 1. 苏州大学附属常州老年病医院,江苏常州 213100;常州市第七人民医院
- 2. 苏州大学医学部公共卫生学院
- 3. 苏州大学附属常州老年病医院,江苏常州 213100;苏州大学医学部公共卫生学院
- 折叠
摘要
目的 了解常州市＞60岁肺部感染者多重耐药菌(multidrug-resistant organism,MDRO)病原学特征及其感染危险因素.方法 收集2019年6月—2022年10月某院重症监护病房(ICU)和呼吸科＞60岁肺部感染者的临床资料,分析病原菌分布情况,采用单因素方差分析和多因素logistic回归分析老年肺部MDRO感染的危险因素.结果 共纳入1 464例老年肺部感染者,MDRO感染发生率13.52％,呼吸道标本分离出309株MDRO,主要为铜绿假单胞菌、肺炎克雷伯杆菌、溶血性葡萄球菌和金黄色葡萄菌属.多因素logistic回归分析显示,长期卧床者MDRO感染风险是非长期卧床者的4.70倍(95％CI:2.13～10.37),机械通气时间≥7 d的患者是＜7 d的3.32倍(95％CI:1.41～7.79),差异均有统计学意义(P值均＜0.01).结论 临床治疗中应对长期卧床及长时间机械通气的老年肺部感染者尽早进行针对性治疗干预,以降低患者MDRO感染的风险,提高生存率.
Abstract
Objective To investigate the etiological characteristics and risk factors of multidrug-resistant organisms among the elderly with pulmonary infections and at ages of over 60 years in a hospital in Changzhou City.Methods The clinical data pertaining to the elderly patients with pulmonary infections and at ages of over 60 years admitted to Intensive Care Unit(ICU)and Department of Respiratory Medicine in a hospital in Changzhou City during the period between June 2019 and October 2022 were collected,and the pathogen distribution was analyzed.The risk factors of multidrug-resistant organisms(MDRO)infection in the lung were identified among the elderly patients using univariate analysis of variance and multivariate logistic regression analysis.Results A total of 1 464 elderly patients with pulmonary infections were enrolled,and the incidence of MDRO was 13.52％.A total of 309 MDRO isolates were found in specimens sampled from respiratory tract,which were mainly characterized as Pseudomonas aeruginosa,Klebsiella pneumoniae,Staphylococcus haemolyticus and S.aureus.Multivariate logistic regression analysis showed a 4.70-fold higher risk of MDRO infections a-mong long-term bedridden patients than among non-long-term bedridden patients[95％confidential interval(CI):(2.13,10.37),P＜0.01]and a 3.32-fold higher risk among patients with mechanical ventilation time of 7 days and longer than among those with me-chanical ventilation time of less than 7 days[95％CI:(1.41,7.79),P＜0.01].Conclusions Targeted interventions should be giv-en to the elderly patients with pulmonary infections with long-term bedridden procedures and long-term mechanical ventilation to reduce the risk of MDRO infection and improve the survival rate.
关键词
肺部感染/多重耐药菌/病原学/危险因素Key words
Pulmonary infection/Multidrug-resistant organism/Etiology/Risk factor引用本文复制引用
出版年
2024
NETL
NSTL
万方数据