CAJ | 학술논문

目的探讨医院败血症的危险因素,减少医源性因素所致败血症风险.方法收集2006年1月至2009年12月期间在本院住院的菌血症患者资料.根据医院感染的定义将这些患者分为医院败血症组(83例)和社区获得性败血症组(119例),对2组临床资料进行统计,对筛选出的可能危险因素进行多因素logistic回归分析.结果与社区获得性败血症相比较,医院败血症患者患恶性肿瘤的比例较高(21/83 vs 12/119,x2=8.2846,P＜0.01),使用静脉留置导管比例高(28/83 vs3/119,x2=36.67,P＜0.01),接受手术者比例高(37/83 vs 0/119,x2=68.226,P＜0.01),既往使用抗生素比例较高(78/83vs10/119,x2=173.5657,P＜0.01).多因素logistic同归分析示:伴有糖尿病者(P＜0.001,OR =4.821)、患恶性肿瘤者(P＜0.05,OR =3.186)、有静脉留置导管者(P＜0.05,OR =2.135)及既往不当抗生素治疗者(P＜0.05,OR=2.135)更易患医院败血症.且医院败血症感染细菌耐药率更高.结论医院内败血症严重威胁人类健康,糖尿病、恶性肿瘤、静脉留置导管及抗生素不当使用是相关危险因素.且医院内败血症感染细菌更具耐药性.
목적 탐토의원패혈증적위험인소,감소의원성인소소치패혈증풍험.방법 수집2006년1월지2009년12월기간재본원주원적균혈증환자자료.근거의원감염적정의장저사환자분위의원패혈증조(83례)화사구획득성패혈증조(119례),대2조림상자료진행통계,대사선출적가능위험인소진행다인소logistic회귀분석.결과 여사구획득성패혈증상비교,의원패혈증환자환악성종류적비례교고(21/83 vs 12/119,x2=8.2846,P＜0.01),사용정맥류치도관비례고(28/83 vs3/119,x2=36.67,P＜0.01),접수수술자비례고(37/83 vs 0/119,x2=68.226,P＜0.01),기왕사용항생소비례교고(78/83vs10/119,x2=173.5657,P＜0.01).다인소logistic동귀분석시:반유당뇨병자(P＜0.001,OR =4.821)、환악성종류자(P＜0.05,OR =3.186)、유정맥류치도관자(P＜0.05,OR =2.135)급기왕불당항생소치료자(P＜0.05,OR=2.135)경역환의원패혈증.차의원패혈증감염세균내약솔경고.결론 의원내패혈증엄중위협인류건강,당뇨병、악성종류、정맥류치도관급항생소불당사용시상관위험인소.차의원내패혈증감염세균경구내약성.
Objective To investigate the risk factors for nosocomial bacteremia and decrease the prevalence of nosocomial bacteremia.Methods We collected the data of bacteremia patients in our hospital from January,2006 to December,2009.According to the criterion of nosocomial infection,the patients were divided into nosocomial bacteremia group (83) and community-onset bacteremia group (119).The influence of a series of variables on the development on both types of bacteremia was analyzed by Student＇s t test and x2 test.The risk factors were performed using multivariate logistic regression.Results Compared to that of community-onset bacteremia group,the proportion of malignancy (21/83 vs 12/119,x2 =8.2846,P ＜ 0.01 ),venous catheter ( 28/83 vs 3/119,x2 =36.67,P ＜ 0.01 ),diabetes ( 37/83 vs 0/119,x2 =68.226,P ＜0.05),surgical operation(37/83 vs 0/119,x2 =68.226,P ＜0.01),previous antibiotics(78/83 vs 10/119,x2 =173.5657,P ＜ 0.01 ) in nosocomial bacteremia group were higher.Multivariable logistic regression analysis showed that only 4 factors were significantly and independently responsible for nosocomial bacteremia,They were malignancy ( P ＜ 0.05,OR =3.186),diabetes ( P ＜0.001,OR =4.821 ),venous catheter( P ＜ 0.05,OR =2.135),previous antibiotics ( P ＜ 0.05,OR =2.135 ).The bacteria in nosocomial bacteremia group showed more ability to resist to antibiotics.Conclusions We should pay more attention to the patients with diabetes or malignancy or venous catheter or previous treated with antibiotics.These patients have more chances to develop to nosocomial bacteremia and infect by the drug-resistant bacteria.