[1]张惠民,杜旭升,范亚莉,等.重症肺炎120例多重耐药菌感染情况及影响因素分析[J].陕西医学杂志,2022,51(7):835-838,842.[doi:DOI:10.3969/j.issn.1000-7377.2022.07.016]
　ZHANG Huimin,DU Xusheng,FAN Yali,et al.Situation and influencing factors of multidrug-resistant organism infection in 120 patients with severe pneumonia[J].,2022,51(7):835-838,842.[doi:DOI:10.3969/j.issn.1000-7377.2022.07.016]
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重症肺炎120例多重耐药菌感染情况及影响因素分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年7期
页码:
835-838,842
栏目:
临床研究
出版日期:
2022-07-05

文章信息/Info

Title:
Situation and influencing factors of multidrug-resistant organism infection in 120 patients with severe pneumonia
作者:
张惠民; 杜旭升; 范亚莉; 李建英
(西安市中心医院呼吸与危重症医学科,陕西 西安710004)
Author(s):
ZHANG Huimin; DU Xusheng; FAN Yali; LI Jianying
(Department of Respiratory and Critical Care Medicine,Xi'an Central Hospital,Xi'an 710004,China)
关键词:
重症肺炎;  多重耐药菌;  影响因素;  院内获得性肺炎;  慢性阻塞性肺疾病;  碳青霉烯类药物
Keywords:
Severe pneumonia;  Multidrug-resistant organism;  Influencing factors;  Hospital-acquired pneumonia;  Chronic obstructive pulmonary disease;  Carbapenems drugs
分类号:
R 563.1
DOI:
DOI:10.3969/j.issn.1000-7377.2022.07.016
文献标志码:
A
摘要:
目的:探究重症肺炎患者多重耐药菌(MDRO)感染情况及影响因素。方法:纳入120例重症肺炎患者,分析MDRO感染情况及耐药性。将对≥3类抗菌药物耐药的患者纳入MDRO组,<3类的患者纳入对照组,比较两组的临床资料。使用二元Logistic回归分析影响重症肺炎患者MDRO感染的危险因素。结果:120例重症肺炎患者中,MDRO感染37例(30.83%),分离MDRO菌株49株(27.84%)。重症肺炎患者多重耐药G-对常用抗菌药物均表现出一定的耐药性,多重耐药G+对青霉素、克林霉素、红霉素等的耐药性较高。MDRO组和对照组在疾病类型、侵入性操作时间、慢性阻塞性肺疾病(COPD)、抗菌药物联用以及碳青霉烯类药物使用中比较,差异具有统计学意义(均P<0.05)。院内获得性肺炎(HAP)、侵入性操作时间、COPD、抗菌药物联用以及碳青霉烯类药物使用均为重症肺炎患者MDRO感染的独立危险因素(均P<0.05)。结论:对于重症肺炎患者,尤其是HAP和合并COPD的患者,应尽量减少患者的侵入性操作时间、抗生素联合应用以及碳青霉烯类药物的使用,以降低MDRO发生风险。
Abstract:
Objective:To investigate the situation of multidrug-resistant organism(MDRO)infection and influencing factors in 120 patients with severe pneumonia.Methods:A total of 120 patients with severe pneumonia were included.Patients with resistance to ≥3 types of antimicrobials were included in the MDRO group,and those with <3 types of antimicrobial resistance were included in the control group.The clinical data of the two groups were compared.The risk factors for MDRO infection in patients with severe pneumonia were analyzed by using binary Logistic regression.Results:Among the 120 patients with severe pneumonia,37(30.83%)were infected with MDRO,and 49(27.84%)MDRO strains were isolated.Multidrug-resistant G- bacteria in patients with severe pneumonia showed certain resistance to commonly used antibiotics,and multidrug-resistant G+ bacteria had higher resistance to penicillin,clindamycin and erythromycin.There were statistically significant differences in disease type,invasive procedure time,chronic obstructive pulmonary disease(COPD),combined use of antibiotics,and use of carbapenems between the MDRO group and the control group(all P<0.05).Hospital-acquired pneumonia(HAP),invasive procedure time,COPD,combined use of antibiotics and carbapenems were all independent risk factors for MDRO infection in patients with severe pneumonia(all P<0.05).Conclusion:For patients with severe pneumonia,especially those with HAP and COPD,invasive procedure time,combined use of antibiotics and carbapenems should be minimized to reduce the risk of MDRO.

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备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2019SF-175)
更新日期/Last Update: 2022-07-05