摘要
目的探讨碳青霉烯类抗生素暴露对ICU院内获得性多重耐药菌(MDRO)尿路感染及预后的影响。方法回顾性分析192例ICU院内获得性尿路感染患者的临床资料。根据有无碳青霉烯类抗生素暴露将患者分为碳青霉烯类暴露组(A组)和非碳青霉烯类暴露组(B组),A组再根据碳青霉烯类抗生素应用时间分为A1组(暴露时间> 7 d)和A2组(5 d <暴露时间≤7 d)。比较各组患者MDRO检出率、入住ICU天数及死亡率。结果 192例ICU院内获得性尿路感染患者检出MDRO尿路感染60例,检出率为31. 25%(60/192)。A组患者MDRO检出率及入住ICU天数均高于或长于B组(均P <0. 05),而两组死亡率比较差异无统计学意义(P> 0. 05)。A1组患者MDRO检出率、入住ICU天数及死亡率均高于或长于A2组(均P <0. 05)。结论碳青霉烯类抗生素暴露可增加ICU患者院内获得性MDRO尿路感染的发生,延长患者入住ICU时间,且暴露时间越长,院内获得性MDRO尿路感染率及死亡率越高。
Objective To investigate the effects of carbapenem antibiotics exposure on the nosocomial acquired urinary tract multidrug -resistant organism(MDRO) infection and prognosis in ICU. Methods The clinical data of 192 patients with nosocomial acquired urinary tract infection in ICU were analyzed retrospectively.According to the presence or absence of carbapenem antibiotics exposure ,the patients were divided into carbapenems exposure group (group A) and non-carbapenems exposure group (group B).Group A was further divided into group A1(exposure duration >7 days) and group A2(5 days<exposure duration≤7 days).The MDRO detection rate,ICU stay and mortality were compared among all groups. Results Of 192 ICU patients with nosocomial acquired urinary tract infection ,60 cases suffered from urinary tract MDRO infection with a detection rate of 31.25%(60/192).The detection rate of MDRO and ICU stay in group A were higher or longer than those in group B(all P<0.05),but there was no statistically significant difference in the mortality between the two groups(P>0.05).The MDRO detection rate,ICU stay and mortality in group A1 were higher or longer than those in group A2(all P<0.05). Conclusion Carbapenem antibiotics exposure can increase the incidence of urinary tract MDRO infection in ICU patients and prolong their ICU stay,the longer the exposure duration,the higher the rate of urinary tract MDRO infection and mortality.
作者
杨爱祥
钱进先
赵华
陶唯益
王耀东
吴健
周洁
杨静
YANG Ai-xiang;QIAN Jin-xian;ZHAO Hua;TAO Wei-yi;WANG Yao-dong;WU Jian;ZHOU Jie;YANG Jing(ICU,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou 215008,China;Department of Nephrology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)
出处
《广西医学》
CAS
2018年第23期2809-2811,共3页
Guangxi Medical Journal
关键词
尿路感染
多重耐药菌
院内获得性
碳青霉烯类抗生素
重症监护室
预后
Urinary tract infection
Multidrug-resistant organism
Nosocomial acquired
Carbapenem antibiotics
Intensive care unit
Prognosis
