中国感染控制杂志
中國感染控製雜誌
중국감염공제잡지
Chinese Journal of Infection Control
2015年
10期
701-703,707
,共4页
老年人%肺炎%病原菌%多重耐药%危险因素%医院感染
老年人%肺炎%病原菌%多重耐藥%危險因素%醫院感染
노년인%폐염%병원균%다중내약%위험인소%의원감염
the elderly%pneumonia%pathogen%multidrug-resistance%risk factor%healthcare-associated infection
目的:探讨某院老年患者多重耐药菌(MDRO)肺部感染的危险因素,为其防治提供依据。方法采用回顾性调查方法,选取该院2010年8月—2012年12月发生肺部感染的老年患者188例,其中痰细菌培养结果为MDRO 感染的患者作为病例组(95例),非 MDRO 感染患者作为对照组(93例),分析两组患者的病历资料。结果老年 MDRO 肺部感染患者共分离 MDRO 102株,居前3位的病原菌分别为鲍曼不动杆菌(31.37%),铜绿假单胞菌(25.49%)及耐甲氧西林金黄色葡萄球菌(15.69%)。单因素分析显示,脑血管病或痴呆病史、低蛋白血症、吞咽困难、长期卧床、重症监护病房(ICU)入住史、使用第三/四代头孢菌素、有创操作7项因素均是老年MDRO 肺部感染的危险因素。多因素 logistic 回归分析显示,低蛋白血症(OR=6.02,95%CI :1.50~24.18)、有创操作(OR=6.55,95%CI :1.69~25.44)、长期卧床(OR =6.03,95%CI :1.92~18.91)均是老年患者发生 MDRO肺部感染的独立危险因素。结论老年患者 MDRO 肺部感染是多种因素共同作用的结果,应针对其危险因素制定综合防治措施,预防和控制老年患者 MRDO 肺部感染的发生。
目的:探討某院老年患者多重耐藥菌(MDRO)肺部感染的危險因素,為其防治提供依據。方法採用迴顧性調查方法,選取該院2010年8月—2012年12月髮生肺部感染的老年患者188例,其中痰細菌培養結果為MDRO 感染的患者作為病例組(95例),非 MDRO 感染患者作為對照組(93例),分析兩組患者的病歷資料。結果老年 MDRO 肺部感染患者共分離 MDRO 102株,居前3位的病原菌分彆為鮑曼不動桿菌(31.37%),銅綠假單胞菌(25.49%)及耐甲氧西林金黃色葡萄毬菌(15.69%)。單因素分析顯示,腦血管病或癡呆病史、低蛋白血癥、吞嚥睏難、長期臥床、重癥鑑護病房(ICU)入住史、使用第三/四代頭孢菌素、有創操作7項因素均是老年MDRO 肺部感染的危險因素。多因素 logistic 迴歸分析顯示,低蛋白血癥(OR=6.02,95%CI :1.50~24.18)、有創操作(OR=6.55,95%CI :1.69~25.44)、長期臥床(OR =6.03,95%CI :1.92~18.91)均是老年患者髮生 MDRO肺部感染的獨立危險因素。結論老年患者 MDRO 肺部感染是多種因素共同作用的結果,應針對其危險因素製定綜閤防治措施,預防和控製老年患者 MRDO 肺部感染的髮生。
목적:탐토모원노년환자다중내약균(MDRO)폐부감염적위험인소,위기방치제공의거。방법채용회고성조사방법,선취해원2010년8월—2012년12월발생폐부감염적노년환자188례,기중담세균배양결과위MDRO 감염적환자작위병례조(95례),비 MDRO 감염환자작위대조조(93례),분석량조환자적병력자료。결과노년 MDRO 폐부감염환자공분리 MDRO 102주,거전3위적병원균분별위포만불동간균(31.37%),동록가단포균(25.49%)급내갑양서림금황색포도구균(15.69%)。단인소분석현시,뇌혈관병혹치태병사、저단백혈증、탄인곤난、장기와상、중증감호병방(ICU)입주사、사용제삼/사대두포균소、유창조작7항인소균시노년MDRO 폐부감염적위험인소。다인소 logistic 회귀분석현시,저단백혈증(OR=6.02,95%CI :1.50~24.18)、유창조작(OR=6.55,95%CI :1.69~25.44)、장기와상(OR =6.03,95%CI :1.92~18.91)균시노년환자발생 MDRO폐부감염적독립위험인소。결론노년환자 MDRO 폐부감염시다충인소공동작용적결과,응침대기위험인소제정종합방치조시,예방화공제노년환자 MRDO 폐부감염적발생。
Objective To evaluate risk factors for multidrug-resistant organisms(MDRO)pulmonary infection in elderly patients in a hospital, and provide scientific basis for prevention and control of MDRO infection. Methods 188 elderly patients who developed pulmonary infection between August 2010 and December 2012 were divided into MDR group (n=95)and non-MDR group (n=93)according to sputum bacterial culture results,clini-cal data of two groups of patients were analyzed.Results 102 strains of MDROs were isolated from patients with MDRO pulmonary infection,the top three were Acinetobacter baumannii (31 .37%),Pseudomonas aeruginosa (25.49%),and methicillin-resistant Staphylococcus aureus (15.69%).Univariate analysis showed that 7 risk fac-tors for MDRO pulmonary infection in elderly patients were history of cerebrovascular disease or dementia,hy-poproteinemia,dysphagia,bedridden,history of ICU hospitalization,recent application of 3,4-generation cephalo-sporins,and invasive procedures.Multivariate logistic regression analysis showed that hypoproteinemia (OR,6.02 [95%CI ,1 .50-24.18]),invasive procedures (OR,6.55 [95%CI,1.69-25.44]),and bedridden (OR,6.03 [95%CI, 1.92-18.91])were independent risk factors for MDRO pulmonary infection in elderly patients.Conclusion Multiple factors contribute to MDRO pulmonary infection in elderly patients,comprehensive prevention and control measures should be taken against the risk factors,so as to prevent and control MRDO pulmonary infection in elderly patients.