国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2013年
5期
602-605
,共4页
杨莉梅%邹丽君%胡雪梅%李素%刘彩霞%朱庆伟
楊莉梅%鄒麗君%鬍雪梅%李素%劉綵霞%硃慶偉
양리매%추려군%호설매%리소%류채하%주경위
泌尿道%产ESBLs大肠埃希菌%医院感染%危险因素%病例对照%干预措施
泌尿道%產ESBLs大腸埃希菌%醫院感染%危險因素%病例對照%榦預措施
비뇨도%산ESBLs대장애희균%의원감염%위험인소%병례대조%간예조시
Urinary tract%ESBLs-producing Escherichia coli%Nosocomial infection%Risk factors%Case-control%Intervenion measures
目的 探究泌尿道产ESBLs大肠埃希菌医院感染的危险因素及控制效果.方法 将46例泌尿道产ESBLs大肠埃希菌医院感染患者设为观察组,按照1∶1比例选同病种同病区非产ESBLs大肠埃希菌医院感染患者为对照组,通过病例对照研究,以条件Logistic法筛选出泌尿道产ESBLs大肠埃希菌医院感染危险因素,并针对这些因素采取相应的控制措施,前瞻性观察感染控制效果.结果 住院时间长、泌尿道留置引流管、先期使用第3代头孢菌素及使用多种抗菌药物(≥3种)经单因素和多因素分析有统计学意义；采取相应控制措施后,在泌尿道大肠埃希菌医院感染病例中,产ESBLs菌株检出率从2011年的57％降至2012年的31％.结论 住院时间长、泌尿道留置引流管、先期使用第3代头孢菌素及使用多种抗菌药物(≥3种)是泌尿道产ESBLs大肠埃希菌医院感染的独立危险因素.加强对产ESBLs菌株的认识、切断传播途经、严格控制广谱抗生素的使用、正确留置尿路引流管、缩短患者住院时间是控制泌尿道产ESBLs大肠埃希菌医院感染的有效措施.
目的 探究泌尿道產ESBLs大腸埃希菌醫院感染的危險因素及控製效果.方法 將46例泌尿道產ESBLs大腸埃希菌醫院感染患者設為觀察組,按照1∶1比例選同病種同病區非產ESBLs大腸埃希菌醫院感染患者為對照組,通過病例對照研究,以條件Logistic法篩選齣泌尿道產ESBLs大腸埃希菌醫院感染危險因素,併針對這些因素採取相應的控製措施,前瞻性觀察感染控製效果.結果 住院時間長、泌尿道留置引流管、先期使用第3代頭孢菌素及使用多種抗菌藥物(≥3種)經單因素和多因素分析有統計學意義；採取相應控製措施後,在泌尿道大腸埃希菌醫院感染病例中,產ESBLs菌株檢齣率從2011年的57％降至2012年的31％.結論 住院時間長、泌尿道留置引流管、先期使用第3代頭孢菌素及使用多種抗菌藥物(≥3種)是泌尿道產ESBLs大腸埃希菌醫院感染的獨立危險因素.加彊對產ESBLs菌株的認識、切斷傳播途經、嚴格控製廣譜抗生素的使用、正確留置尿路引流管、縮短患者住院時間是控製泌尿道產ESBLs大腸埃希菌醫院感染的有效措施.
목적 탐구비뇨도산ESBLs대장애희균의원감염적위험인소급공제효과.방법 장46례비뇨도산ESBLs대장애희균의원감염환자설위관찰조,안조1∶1비례선동병충동병구비산ESBLs대장애희균의원감염환자위대조조,통과병례대조연구,이조건Logistic법사선출비뇨도산ESBLs대장애희균의원감염위험인소,병침대저사인소채취상응적공제조시,전첨성관찰감염공제효과.결과 주원시간장、비뇨도류치인류관、선기사용제3대두포균소급사용다충항균약물(≥3충)경단인소화다인소분석유통계학의의；채취상응공제조시후,재비뇨도대장애희균의원감염병례중,산ESBLs균주검출솔종2011년적57％강지2012년적31％.결론 주원시간장、비뇨도류치인류관、선기사용제3대두포균소급사용다충항균약물(≥3충)시비뇨도산ESBLs대장애희균의원감염적독립위험인소.가강대산ESBLs균주적인식、절단전파도경、엄격공제엄보항생소적사용、정학류치뇨로인류관、축단환자주원시간시공제비뇨도산ESBLs대장애희균의원감염적유효조시.
Objective To explore the risk factors and control effects of nosocomial urinary tract infection due to ESBLs-producing Escherichia coli.Methods 46 patients with nosocomial urinary tract infection due to ESBLs-producing Escherichia coli were assigned to the study group,and another 46 patients with the same urinary tract infection not due to ESBLs-producing Escherichia coli were assigned to the control group.A case-control study was conducted.Conditional logistic regression was used to screen the risk factors of nosocomial urinary tract infection due to ESBLs-producing Escherichia coli; and the corresponding control techniques were applied to assess the results of infection control prospectively.Results Longer length of hospital stay,uses of indwelling urinary tube,early use of the third generation cephalosporin,and use of multiple antibacterials (≥ 3 types) had a statistical significance by univariate and multi-univariate analysis.After the corresponding control measures were taken,the detection rate of ESBLs-producing strains of Escherichia coli declined from 57％ in 2011 to 31％ in 2012.Conclusions Longer length of hospital stays,use of indwelling urinary tube,early use of the third generation cephalosporin,and use of multiple antibacterials (≥ 3 types) are the independent risk factors for nosocomial urinary tract infection due to ESBLs-producing Escherichia coli.Strengthened awareness of ESBLs-producing strains,termination of transmission route,strict control of broad-spectrum antibiotic uses,correct placement of urinary tube,and shorter length of hospital stay are effective measures for controlling nosocomial urinary tract infection due to ESBLs-producing Escherichia coli.
