本文選題：多重耐藥肺炎克雷伯菌 + 感染高危因素�。� 參考：《上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年07期

【摘要】：目的·分析多重耐藥肺炎克雷伯菌(MDR-Kpn)感染的高危因素及不同治療方案的療效差異。方法·收集并分離醫(yī)院內(nèi)110株MDR-Kpn,進(jìn)行藥敏試驗(yàn)。通過(guò)查詢電子病歷系統(tǒng),51例患者為MDR-Kpn感染組;同病區(qū)相同基礎(chǔ)疾病且分離到Kpn的51例患者作為對(duì)照組。對(duì)MDR-Kpn感染和對(duì)照組患者共39項(xiàng)臨床指標(biāo)進(jìn)行單因素分析,對(duì)有統(tǒng)計(jì)學(xué)意義的變量進(jìn)行多因素Logistic回歸分析。將感染組患者,按治療結(jié)局分為治療無(wú)效組和有效組,比較抗生素使用時(shí)間。結(jié)果·藥敏試驗(yàn)結(jié)果顯示:110株MDR-Kpn對(duì)磺胺類(lèi)、磷霉素和阿米卡星的敏感性較高。單因素分析結(jié)果顯示:輸血、有創(chuàng)通氣、吸痰等12個(gè)臨床指標(biāo)為感染高危因素(P0.05)。有效組(28例)和無(wú)效組(23例)在抗生素的使用時(shí)間上比較,碳青霉烯類(lèi)的差異有統(tǒng)計(jì)學(xué)意義(P=0.025)。結(jié)論·控制和消除高危因素對(duì)預(yù)防及減少M(fèi)DR-Kpn的感染生長(zhǎng)有積極意義;合理使用碳青霉烯類(lèi)抗生素對(duì)預(yù)后有利。
[Abstract]:Objective to analyze the high risk factors of multidrug resistant Klebsiella pneumoniae (MDR-Kpn) infection and the difference of therapeutic effects. Methods 110 strains of MDR-Kpn were collected and isolated from the hospital. 51 patients with MDR-Kpn infection were investigated by the electronic medical record system, and 51 patients with the same basic diseases and Kpn were used as control group. The 39 clinical indexes of MDR-Kpn infection and control group were analyzed by univariate analysis and multivariate logistic regression analysis of statistically significant variables. The patients in the infected group were divided into two groups according to the outcome of the treatment: the ineffective group and the effective group. Results the sensitivity of MDR-Kpn to sulfonamides, fosfomycin and amikacin was higher. Univariate analysis showed that blood transfusion, invasive ventilation, sputum aspiration and other 12 clinical indicators were high risk factors of infection (P0.05). In the effective group (28 cases) and the ineffective group (23 cases), there was a significant difference in the use time of carbapenems (P0. 025). Conclusion the control and elimination of high risk factors have positive significance in preventing and reducing the infection and growth of MDR-Kpn, and the rational use of carbapenem antibiotics is beneficial to the prognosis.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬仁濟(jì)醫(yī)院檢驗(yàn)科;
【基金】：上海青年臨床醫(yī)技人才培養(yǎng)資助計(jì)劃(滬醫(yī)衛(wèi)基[2016]05號(hào))~~
【分類(lèi)號(hào)】：R446.5
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本文編號(hào)：2088754