天津医科大学学报
天津醫科大學學報
천진의과대학학보
Journal of Tianjin Medical University
2015年
5期
418-422
,共5页
耐甲氧西林金黄色葡萄球菌%危险因素%重症监护病房
耐甲氧西林金黃色葡萄毬菌%危險因素%重癥鑑護病房
내갑양서림금황색포도구균%위험인소%중증감호병방
methicillin-resistant Staphylococcus aureus%risk factors%intensive care unit
目的:研究重症监护病房(ICU)耐甲氧西林金黄色葡萄球菌(MRSA)感染的发生率和危险因素,为采取措施预防与控制MRSA感染提供科学依据. 方法:2012-2013年天津市某三级甲等医院综合ICU内MRSA感染患者作为病例组,非MRSA感染患者作为对照组,采用流行病学研究方法,根据综述、专家咨询以及实际工作经验,最终确定变量进行危险因素分析;应用非条件Logistic回归分析对资料进行单因素分析与多因素分析, 寻找MRSA感染的独立危险因素. 结果:MRSA感染发生率为62.79%, 其中,2012年发生率为68.18%,2013年发生率为57.14%,MRSA感染部位以下呼吸道为主;Logistic回归统计分析显示: 年龄(OR=1.047,95%CI:1.009~1.086)、ICU住院时间(OR=1.050,95%CI:1.012~1.089)、 使用激素/免疫抑制剂(OR=2.853,95%CI:1.177~6.911)、 机械通气(OR=4.918,95%CI:1.175~20.583)、 抗菌药物使用超过7 d (OR=3.257,95%CI:1.055~10.058)是MRSA感染的独立危险因素. 结论:高龄、长期入住ICU、进行机械通气、使用激素/免疫抑制剂、长期使用抗菌药物是ICU内MRSA感染的危险因素.
目的:研究重癥鑑護病房(ICU)耐甲氧西林金黃色葡萄毬菌(MRSA)感染的髮生率和危險因素,為採取措施預防與控製MRSA感染提供科學依據. 方法:2012-2013年天津市某三級甲等醫院綜閤ICU內MRSA感染患者作為病例組,非MRSA感染患者作為對照組,採用流行病學研究方法,根據綜述、專傢咨詢以及實際工作經驗,最終確定變量進行危險因素分析;應用非條件Logistic迴歸分析對資料進行單因素分析與多因素分析, 尋找MRSA感染的獨立危險因素. 結果:MRSA感染髮生率為62.79%, 其中,2012年髮生率為68.18%,2013年髮生率為57.14%,MRSA感染部位以下呼吸道為主;Logistic迴歸統計分析顯示: 年齡(OR=1.047,95%CI:1.009~1.086)、ICU住院時間(OR=1.050,95%CI:1.012~1.089)、 使用激素/免疫抑製劑(OR=2.853,95%CI:1.177~6.911)、 機械通氣(OR=4.918,95%CI:1.175~20.583)、 抗菌藥物使用超過7 d (OR=3.257,95%CI:1.055~10.058)是MRSA感染的獨立危險因素. 結論:高齡、長期入住ICU、進行機械通氣、使用激素/免疫抑製劑、長期使用抗菌藥物是ICU內MRSA感染的危險因素.
목적:연구중증감호병방(ICU)내갑양서림금황색포도구균(MRSA)감염적발생솔화위험인소,위채취조시예방여공제MRSA감염제공과학의거. 방법:2012-2013년천진시모삼급갑등의원종합ICU내MRSA감염환자작위병례조,비MRSA감염환자작위대조조,채용류행병학연구방법,근거종술、전가자순이급실제공작경험,최종학정변량진행위험인소분석;응용비조건Logistic회귀분석대자료진행단인소분석여다인소분석, 심조MRSA감염적독립위험인소. 결과:MRSA감염발생솔위62.79%, 기중,2012년발생솔위68.18%,2013년발생솔위57.14%,MRSA감염부위이하호흡도위주;Logistic회귀통계분석현시: 년령(OR=1.047,95%CI:1.009~1.086)、ICU주원시간(OR=1.050,95%CI:1.012~1.089)、 사용격소/면역억제제(OR=2.853,95%CI:1.177~6.911)、 궤계통기(OR=4.918,95%CI:1.175~20.583)、 항균약물사용초과7 d (OR=3.257,95%CI:1.055~10.058)시MRSA감염적독립위험인소. 결론:고령、장기입주ICU、진행궤계통기、사용격소/면역억제제、장기사용항균약물시ICU내MRSA감염적위험인소.
Objective:To study the incidence rate and risk factors of infection caused by methicillin-resistant staphylococcus aureus (MRSA) in the intensive care unit (ICU) so as to provide scientific data for measures to prevent and control MRSA infections. Methods:From Jan 1,2012 to Dec 31,2013,the patients with MRSA infections in general ICU were selected as the case group while the patients without MRSA infections in general ICU were set as the control group;by means of epidemiological survey,the variables and risk factors were determined according to the review,advice by experts and work experience. Non-conditional logistic regression analysis model was used for single factor and multi-factor analysis to acquire independent risk factors of MRSA infections in ICU. Results:The results showed that the incidence rate was 62.79%. Among them,the incidence rate in 2012 was 68.18%,while the incidence rate in 2013 was 57.14%. The lower respiratory tract was the major part in MRSA infection. Logistic regression analysis showed that age (OR=1.047,95%CI:1.009~1.086), length of ICU stay (OR=1.050,95%CI:1.012~1.089), steroid administration (OR=2.853,95%CI:1.177~6.911),mechanical ventilation(MV)(OR=4.918,95%CI:1.175~20.583) and duration of drug therapy longer than 7 days(OR=3.257,95%CI:1.055~10.058) were the independent risk factors. Conclusion:Age, length of ICU stay , use of hormones , mechanical ventilation and long-term use of antimicrobial agents are the risk factors for the bacterial infection in ICU.
