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

卷:

25卷

期数:

2019年03期

页码:

271-274,284

栏目:

临床医学

出版日期:

2019-05-20

文章信息/Info

Title:

Related risk factors for infection and prognosis of Carbapenem-resistant Klebsiella pneumoniae

文章编号:

1006-8147(2019)03-0271-05

作者:

唐洪影; 李 静; 宋缘缘; 田 彬; 胡志东

（天津医科大学总医院医学检验科，天津300052）

Author(s):

TANG Hong-ying;  LI Jing;  SONG Yuan-yuan;  TIAN Bin;  HU Zhi-dong

（Department of Clinical Laboratory, General Hospital, Tianjin Medical University, Tianjin 300052, China)

关键词:

碳青霉烯类; 肺炎克雷伯菌; 预后; 危险因素

Keywords:

Carbapenem;  Klebsiella pneumonia;  prognosis;  risk factors

分类号:

R446.5

DOI:

-

文献标志码:

A

摘要:

目的：研究碳青霉烯类耐药肺炎克雷伯菌（CRKP）感染患者的临床特征、感染及预后相关危险因素。方法：采用回顾性研究，对天津医科大学总医院2016年12月-2017年10月感染耐碳青霉烯类肺炎克雷伯菌住院患者的临床资料进行分析，按1:1设计病例-病例对照研究，CRKP感染组71例，匹配碳青霉烯类敏感肺炎克雷伯菌（CSKP）感染组71例作为对照，感染及预后相关危险因素采用单因素及多因素Logistic回归分析。结果：单因素分析显示，患有肝胆疾病、糖尿病，7 d内接受机械通气，近3月内使用碳青霉烯类药物、β-内酰胺酶抑制剂复合制剂、替加环素以及联合使用抗生素均为CRKP的危险因素（P<0.05或P<0.01）；年龄、患有肝胆疾病、肾脏疾病、神经系统疾病、消化系统疾病，7 d内接受动脉穿刺、留置尿管≥3 d，入住ICU天数、分离菌株前住院天数以及总住院天数为CRKP感染患者死亡的危险因素（P<0.05或P<0.01）。多因素Logistic回归分析显示，患有糖尿病，机械通气和联合使用抗生素为CRKP感染的独立危险因素；患有肾脏疾病和神经系统疾病为CRKP感染患者死亡的独立危险因素。结论：临床应合理使用抗菌药物，减少侵袭性操作，改善患者免疫功能，降低CRKP的感染及改善预后。

Abstract:

Objective: To study the clinical characteristics, infection and prognosis risk factors of patients with Carbapenem-resistant Klebsiella pneumoniae（CRKP） infection. Methods: The clinical data ofhospitalized patients with CRKP infection of General Hospital of Tianjin Medical University during December 2016 and October 2017 were retrospectively analyzed, and we designed a 1:1 case-control study, including 71 patients with CRKP bacteremia as experiment group and 71 patient with Carbapenem-sensitive Klebsiella pneumoniae（CSKP）bacteremia as control group. Related risk factors for infection and prognosis were analyzed by univariate and multivariate Logistic regression. Results: Univariate analysis showed that hepatobiliary disease, diabetes mellitus, mechanical ventilationwithin 7 days, use of carbapenems, β-lactamase inhibitor compound , tigecycline and combined antibiotics within 3 months were risk factors for CRKP infection(P<0.05 or P< 0.01); while older age, hepatobiliary disease, renal disease and neurological disease, digestive system disease, arteriopuncturewithin 7 days, indwelling catheter ≥3 days, duration of ICU stay, hospital stay prior to CRKP isolation and length of hospital stay were risk factors for death of patients with CRKP (P < 0.05 or P< 0.01). Multivariate Logistic regression analysis showed that diabetes mellitus, mechanical ventilation and combined antibioticswere independent risk factors for CRKP infection;renal disease and neurological disease were independent risk factors for death from CRKP infection. Conclusion: Rational use of antibiotics, strict control of invasive procedures and improved immune function may reduce the infection of CRKP and improve the prognosis.

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相似文献/References:

[1]余 倩,胡志东,李 静,等.3种方法评估肺炎克雷伯菌及鲍曼不动杆菌对替加环素的体外药敏结果分析[J].天津医科大学学报,2015,21(06):510.
　YU Qian,HU Zhi-dong,LI Jing,et al.Effect of Tigecycline on Klebsiella pneumoniae and Acinetobacter baumanaii by susecptibility testing in vitro[J].Journal of Tianjin Medical University,2015,21(03):510.

备注/Memo

备注/Memo:

作者简介 唐洪影（1993-），女，硕士在读，研究方向：临床检验诊断；通信作者：胡志东， E-mail: huzhidong27@163.com。

常用功能

更新日期/Last Update: 2019-07-03