耐碳青霉烯类黏质沙雷菌医院感染的危险因素分析
Risk factors for nosocomial infections with carbapenem-resistant Serratia marcescens
张蓉晖 1黄芸 1张宇宇 1常燕子 2王广芬 3周华1
作者信息
- 1. 宁波市医疗中心李惠利医院药学部,浙江 315010
- 2. 宁波市医疗中心李惠利医院检验科
- 3. 宁波市医疗中心李惠利医院院感科
- 折叠
摘要
目的 探讨耐碳青霉烯类黏质沙雷菌(carbapenem-resistant Serratia marcescens,CR-SMA)医院感染的危险因素,为临床CR-SMA的预防和控制提供理论依据.方法 收集2016年1月-2022年12月本院医院感染的38例CR-SMA患者为实验组,同时按照1∶1配对收集相同时间段及病区的碳青霉烯类敏感黏质沙雷菌(carbapenem-sen-sitive Serratia marcescens,CS-SMA)的医院感染者为对照组,分别统计2组患者的临床特点及抗菌药物使用情况,对CR-SMA医院感染的危险因素进行单因素及多因素logistic回归分析.结果 单因素敏感性分析显示,医院感染CR-SMA与SMA感染前住院时间≥14 d、糖尿病、合并其他细菌感染、CR-SMA感染前抗菌药物使用时间≥14 d和使用呼吸机有关(P＜0.05).多因素logistic回归分析显示,使用呼吸机和SMA感染前抗菌药物使用时间≥14 d是医院感染CR-SMA的独立危险因素(P＜0.05).结论 使用呼吸机和抗菌药物使用时间长应引起临床重视,对高危人群进行定期监测、加强无菌操作、落实消毒隔离措施并规范使用抗菌药物,降低医院感染的发生,防止耐药菌在院内传播.
Abstract
Objective This paper aims to explore the risk factors for nosocomial infections with carbapenem-resistant Serratia marcescens(CR-SMA),so as to provide theoretical basis for the prevention and control of nosocomial infections with CR-SMA.Methods Thirty-eight patients with CR-SMA nosocomial infections treated from Jan.2016 to Dec.2022 were select-ed as the CR-SMA group,and thirty-eight patients associated with carbapenem-sensitive Serratia marcescens(CS-SMA)were selected at a ratio of 1∶1 and assigned as the CS-SMA group.The clinical characteristics and the usage of antibiotics of the two groups were statistically analyzed.The risk factors for nosocomial infections with CR-SMA were analyzed by univariate and multivariate logistic regression analysis.Results Univariate sensitivity analysis showed that the length of hospitalization stay before SMA infection≥14 d,diabetes,other bacterial infections,the time of antibiotics before CR-SMA infection≥14 d and the use of ventilator(P＜0.05).Multivariate logistic regression analysis showed that the use of ventilator and the time of antibiotics before CR-SMA infection≥ 14 d were independent risk factors for nosocomial infection of CR-SMA(P＜0.05).Conclusion Clinical attention should be paid to the use of ventilators and antibiotics for long duration.High-risk groups should be regularly monitored,aseptic operations should be strengthened,disinfection and isolation measures should be imple-mented,and antibiotics should be standardized to reduce the occurrence of nosocomial infections and prevent the spread of drug-resistant bacteria in hospitals.
关键词
耐碳青霉烯类黏质沙雷菌/医院感染/危险因素Key words
Carbapenem-resistant Serratia marcescens/Nosocomial infections/Risk factors引用本文复制引用
基金项目
浙江省药学会药物经济学与卫生技术评估专项(2022-ZYJ12)
浙江省药学会医院药学专项(2021ZYY41)
宁波市医学重点学科建设项目(2022-F06)
出版年
2023
NETL
NSTL
维普
万方数据