成年住院病人感染耐碳青霉烯类肺炎克雷伯菌的危险因素研究

朱敬蕊; 段缓; 崔琢; 张向君

doi:10.13898/j.cnki.issn.1000-2200.2021.09.012

成年住院病人感染耐碳青霉烯类肺炎克雷伯菌的危险因素研究

Study on the risk factors of carbapenem-resistant Klebsiella pneumoniae infection in adult inpatients

摘要

摘要:
目的分析医院成年住院病人耐碳青霉烯类肺炎克雷伯菌（CRKP）感染的影响因素。
方法收集医院感染肺炎克雷伯菌的成年住院病人临床资料，根据肺炎克雷伯菌对碳青霉烯类抗生素是否耐药，分为CRKP组和碳青霉烯类敏感肺炎克雷伯菌组，分析CRKP感染的影响因素。
结果单因素分析显示，是否入住重症监护室、使用碳青霉烯类抗菌药物、使用呼吸机和使用导尿管在2组间差异均有统计学意义（P < 0.01）。多因素分析显示，入住重症监护室和使用呼吸机均为CRKP感染的独立危险因素（P < 0.01）。
结论加强重症监护室的耐药监测，开展定植筛查，规范使用抗菌药物，重视医务人员无菌操作和手卫生，严格落实消毒隔离措施有助于控制CRKP的传播。

Abstract:
ObjectiveTo analyze the influencing factors of carbapenem-resistant Klebsiella pneumoniae(CRKP) infection in adult inpatients.
MethodsThe clinical data of adult inpatients infected with Klebsiella pneumoniae were collected.According to whether Klebsiella pneumoniae was resistant to carbapenem antibiotics, the patients were divided into the CRKP group and carbapene sensitive Klebsiella pneumoniae(CSKP) group.The influencing factors of CRKP infection were analyzed.
ResultsThe results of univariate analysis showed that the differences of CRKP infection in the admission to intensive care unit, use of carbapenem antibacterial drugs, use of ventilator and use of catheter were statistically significant(P < 0.01).The results of multivariate analysis showed that the admission to intensive care unit and use of ventilator were the independent risk factors of CRKP infection(P < 0.01).
ConclusionsIt is helpful to control the spread of CRKP by strengthening the monitoring of drug resistance in intensive care units, carrying out screening for colonization, standardizing the use of antibiotics, paying attention to aseptic operation and hand hygiene of medical staff, and strictly implementing disinfection and isolation measures.

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