|本期目录/Table of Contents|

[1]杨硕奇,何新飙.重症监护病房内耐甲氧西林金黄色葡萄球菌感染现状分析[J].天津医科大学学报,2015,21(05):418-422.
 YANG Shuo-qi,HE Xin-biao.Status analysis of methicillin-resistant staphylococcus aureus infection in an intensive care unit[J].Journal of Tianjin Medical University,2015,21(05):418-422.
点击复制

重症监护病房内耐甲氧西林金黄色葡萄球菌感染现状分析(PDF)
分享到:

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
21卷
期数:
2015年05期
页码:
418-422
栏目:
临床医学
出版日期:
2015-09-20

文章信息/Info

Title:
Status analysis of methicillin-resistant staphylococcus aureus infection in an intensive care unit
文章编号:
1006-8147(2015)05-0418-05
作者:
杨硕奇何新飙
(天津医科大学第二医院ICU,天津 300211)
Author(s):
YANG Shuo-qi HE Xin-biao
(ICU,The Second Hospital,Tianjin Medical University, Tianjin 300211,China)
关键词:
耐甲氧西林金黄色葡萄球菌危险因素重症监护病房
Keywords:

text-align: left" align="left">methicillin-resistant Staphylococcus aureusrisk factorsintensive care unit

分类号:
R515
DOI:
-
文献标志码:
A
摘要:
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:1.0091.086)、ICU住院时间(OR= 1.050,95%CI:1.0121.089)、使用激素/免疫抑制剂(OR= 2.853,95%CI:1.1776.911)、机械通气(OR= 4.918,95%CI:1.17520.583)、抗菌药物使用超过7 d(OR= 3.257,95%CI:1.05510.058)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。
Abstract:

Objective : To study the incidence rate and risk factors of infection caused by methicillin-resistant staphylococcus aureus (MRSA) in the intensive care unit so as to provide scientific data for measures to prevent and control MRSA infections. Methods  Form Jan 1,2012 to Dec 31,2013,the patients with MRSA infections in general intensive care unit 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,consultant to 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. ResultsThe 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:1.0091.086), length of ICU stay(OR= 1.050,95%CI:1.0121.089), steroid administration(OR= 2.853,95%CI:1.1776.911),mechanical ventilation(MV)(OR= 4.918,95%CI:1.17520.583) and duration of drug therapy longer than 7 days (OR= 3.257,95%CI:1.05510.058) 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.

参考文献/References:

[1] Jevons MP. “Celbenin”- resistant staphylococci [J]. Br Med J, 1961,14 (4) : 385
[2]Clinical, Laboratory Standards Institute. Performance standards for antimierobial susceptibility testing[M]. PA:CLSI, 2012: MS22
[3]朱任媛,张小江,杨启文,等. 卫生部全国细菌耐药监测网2011年ICU来源细菌耐药监测[J]. 中国临床药理学杂志, 2012,28(12):905
[4]周宏,康海全,任玲,等. MRSA医院感染的特点及预防措施的研究[J]. 中华全科医学, 2009,7(10):1043
[5]Deurenberg R H, Nulens E, Valvatne H, et al. Cross-border dissemination of methicillin-resistant Staphylococcus aureus, Euregio Meuse-Rhin region[J]. Emerg Infect Dis, 2009,15(5):727
[6]张亚莉,周宏伟,马骊,等. 医患鼻前庭携带耐甲氧西林金黄色葡萄球菌与医院感染菌同源性的研究[J]. 南方医科大学学报, 2006,26(5):635
[7]陈法余,张俭,林乐清,等. ICU呼吸机相关性肺炎发生的危险因素及病原菌研究[J]. 中华医院感染学杂志, 2011,21(22):4687
[8]张译文,胡必杰,高晓东,等. 综合干预措施对呼吸机相关性肺炎发病率的影响[J]. 中华医院感染学杂志, 2010,20(12):1688
[9]Hawkins C, Huang J, Jin N, et al. Persistent staphylococcus aureus bacteremia: an analysis of risk factors and outcomes[J]. Arch Intern Med, 2007,167(17):1861
[10] 库宝善.药理学 [M] .北京:北京大学医学出版社,2004:341-343
[11]吴华,李丹. 重症监护病房临床与环境、手分离耐药革兰阴性杆菌的同源性研究[J]. 中华医院感染学杂志, 2008,18(7):909
[12]林金兰,李六亿. 耐甲氧西林金黄色葡萄球菌医院感染危险因素调查分析[J]. 中华医院感染学杂志, 2012,22(21):4809
[13]Rodríguez-Ba?o J, Millán A B, Domínguez M A, et al. Impact of inappropriate empirical therapy for sepsis due to health care-associated methicillin-resistant Staphylococcus aureus[J]. J Infect, 2009,58(2):131
[14]Calfee D P, Salgado C D, Milstone A M, et al. Strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in acute care hospitals: 2014 update[J]. Infect Control Hosp Epidemiol, 2014,35(7):772

相似文献/References:

[1]陈慧娥,杨海燕,侯宁,等.缺血性视神经病变临床分析[J].天津医科大学学报,2013,19(05):416.
[2]苏东峰,聂秀玲,孙丽荣.2型糖尿病合并高尿酸血症临床特征及相关危险因素分析[J].天津医科大学学报,2013,19(06):481.
[3]张程征,袁如玉.女性早发急性冠脉综合征血压变异性的研究[J].天津医科大学学报,2014,20(02):127.
 ZHANG Cheng-zheng,YUAN Ru-yu.Blood pressure variability in female patients with premature acute coronary syndrome[J].Journal of Tianjin Medical University,2014,20(05):127.
[4]何汶潼,毛富强,李 申,等.医学生进食障碍心理社会危险因素调查分析[J].天津医科大学学报,2015,21(05):449.
[5]蒿若楠,胡 芳,张 杰,等.PICC相关性上肢深静脉血栓形成危险因素分析及风险模型的建立[J].天津医科大学学报,2016,22(02):147.
 HAO Ruo-nan,HU Fang,ZHANG Jie,et al.Analysis of risk factors and establishment of risk model for peripherally inserted central catheter thrombosis[J].Journal of Tianjin Medical University,2016,22(05):147.
[6]张 燕,何新飙.ICU患者感染鲍曼不动杆菌的危险因素及耐药性分析[J].天津医科大学学报,2016,22(04):318.
 ZHANG Yan,HE Xin-biao.Analysis of risk factors and drug resistance of the patients fected with Acinetobater baumanii in intensive care unit[J].Journal of Tianjin Medical University,2016,22(05):318.
[7]许丹丹,王茹瑶,刘 蕊,等.老年结直肠癌的危险因素及与循环IGF-1水平的相关性研究[J].天津医科大学学报,2016,22(05):424.
 XU Dan-dan,WANG Ru-yao,LIU Rui,et al.Research on the risk factors of senile colorectal cancer and the correlation with circulating insulin-like growth factor-1[J].Journal of Tianjin Medical University,2016,22(05):424.
[8]孟 甲,魏 芳,王立华,等.终末期肾病血液透析相关性腹水发生情况及其相关危险因素的探讨[J].天津医科大学学报,2017,23(02):112.
[9]陈可新,郝晓东,薄志强,等.≤pT2N0M0膀胱癌根治术后近期复发的影响因素分析[J].天津医科大学学报,2017,23(04):357.
 CHEN Ke-xin,HAO Xiao-dong,BO Zhi-qiang,et al.Influencing factors and prognosis of short-term relapse after radical cystectomy of primary bladder cancer(≤pT2N0M0)[J].Journal of Tianjin Medical University,2017,23(05):357.
[10]孔 媛,于泳浩.全凭静脉麻醉下神经外科手术急性肾损伤高危因素回顾性分析[J].天津医科大学学报,2018,24(01):47.
 KONG Yuan,YU Yong-hao.Retrospective analysis of high risk factors for acute renal injury in neurosurgical patients under total intravenous anesthesia[J].Journal of Tianjin Medical University,2018,24(05):47.

备注/Memo

备注/Memo:
基金项目 天津市自然科学基金资助项目 ( 09JCYBJC11300 )
作者简介 杨硕奇(1988-),女,硕士在读, 研究方向:全科医学;
通信作者:何新飙, E-mail : hexinbiaoqz@163.com 。
更新日期/Last Update: 2015-09-22