CAJ | 학술논문

目的探讨肠球菌属医院感染的危险因素,以制定有效的防护措施.方法回顾性分析安徽医科大学第一附属医院2011年1月至12月肠球菌感染的193例患者的临床资料,对可能导致肠球菌感染的相关因素进行分析,筛选临床危险因素.结果胆道外科手术(OR=1.264,95％CI为1.141～1.401,P=0.000)、插引流管(OR=1.619,95％CI为0.301～4.190,P=0.010)、泌尿道插管(OR=2.001,95％CI为1.739～3.803,P=0.000)、头孢三代(OR=2.085,95％ CI为1.181～3.682,P=0.011)和碳青霉烯类(OR=1.473,95％CI为1.060～2.023,P=0.024)抗菌药物的使用是肠球菌属感染的危险因素;胆道外科手术(OR=4.861,95％CI为3.029～7.802,P=0.000)及泌尿道插管(OR=2.737,95％CI为1.764～4.246,P=0.002)是粪肠球菌和屎肠球菌感染的共同危险因素;插引流管(OR=1.861,95％CI为1.702～1.911,P=0.038)、使用头孢三代(OR=1.122,95％CI为1.022～1.224,P=0.016)和碳青霉烯类(OR=3.051,95％CI为1.185～7.855,P=0.021)抗菌药物是屎肠球菌感染的独立危险因素.结论临床应针对肠球菌属感染可能的危险因素,提高手术技术、加强侵入性操作的过程管理、规范抗菌药物的使用,从而减少医院肠球菌感染的发生.
목적 탐토장구균속의원감염적위험인소,이제정유효적방호조시.방법 회고성분석안휘의과대학제일부속의원2011년1월지12월장구균감염적193례환자적림상자료,대가능도치장구균감염적상관인소진행분석,사선림상위험인소.결과 담도외과수술(OR=1.264,95％CI위1.141～1.401,P=0.000)、삽인류관(OR=1.619,95％CI위0.301～4.190,P=0.010)、비뇨도삽관(OR=2.001,95％CI위1.739～3.803,P=0.000)、두포삼대(OR=2.085,95％ CI위1.181～3.682,P=0.011)화탄청매희류(OR=1.473,95％CI위1.060～2.023,P=0.024)항균약물적사용시장구균속감염적위험인소;담도외과수술(OR=4.861,95％CI위3.029～7.802,P=0.000)급비뇨도삽관(OR=2.737,95％CI위1.764～4.246,P=0.002)시분장구균화시장구균감염적공동위험인소;삽인류관(OR=1.861,95％CI위1.702～1.911,P=0.038)、사용두포삼대(OR=1.122,95％CI위1.022～1.224,P=0.016)화탄청매희류(OR=3.051,95％CI위1.185～7.855,P=0.021)항균약물시시장구균감염적독립위험인소.결론 림상응침대장구균속감염가능적위험인소,제고수술기술、가강침입성조작적과정관리、규범항균약물적사용,종이감소의원장구균감염적발생.
Objective To determine the risk factors of nosocomial infections caused by Enterococcus,and to develop effective protective measures.Methods A retrospective study was conducted among 193 patients who had been infected by Enterococcus from Jan.2011 to Dec.2011 in the First Affiliated Hospital of Anhui Medical University.Clinical data were collected and related risk factors for enterococcal infection were screened.Results The risk factors for enterococcal infection included biliary tract surgery (OR=1.264,95％CI:1.141-1.401,P =0.000),drainage tube intubation (OR=1.619,95％CI:0.301-4.190,P=0.010),urinary tract intubation (OR=2.001,95％CI:1.739-3.803,P 0.000),uses of third generation cephalosporin (OR=2.085,95％CI:1.181-3.682,P=0.011) andcarbapenems (OR=1.473,95％CI:1.060-2.023,P =0.024).Furthermore,biliary tract surgery (OR=4.861,95％CI:3.029-7.802,P=0.000) and urinary tract intubation (OR=2.737,95％CI:1.764-4.246,P=0.002) were risk factors for both Enterococcus faecalis and Enterococcus faecium infection,while drainage tube intubation (CR =1.861,95％CI:1.702 1.911,P=0.038),uses of the third generation cephalosporin (OR=1.122,95％CI:1.022-1.224,P=0.016) and carbapenems (OR=3.051,95％CI:1.185-7.855,P=0.021) were independent risk factors for Enterococcus faecium infection.Conclusions Surveillance