Surveillance of multi-drug-resistant bacterial infections in patients with malignant tumors in a hospital and analysis of risk factors
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摘要: 目的 调查某院恶性肿瘤患者多重耐药菌(MDRO)感染情况及危险因素。 方法 选取2014年1月—2017年12月儋州市人民医院收治的恶性肿瘤患者1 280例,根据其药敏试验结果分为MDRO感染组(270例)和非MDRO感染组(1 010例),分析MDRO的检出情况。应用多因素logistic回归分析分析恶性肿瘤患者MDRO感染的危险因素。 结果 1 280例恶性肿瘤患者,MDRO感染发生率为21.09%(270/1 280)。270例MDRO感染患者共检出多重耐药菌菌株295株,居前3位的分别为鲍曼不动杆菌(31.19%)、铜绿假单胞菌(23.05%)及大肠埃希菌(19.32%)。Logistic回归分析显示,长期卧床(OR=2.804,95%CI:1.725~4.364)、侵入性操作(OR=3.907,95%CI:2.914~7.523)、使用抗菌药物种类(OR=5.306,95%CI:4.105~9.248)、使用抗菌药物时间(OR=3.117,95%CI:2.208~6.731)、低白蛋白水平(OR=2.105,95%CI:1.286~3.740)是恶性肿瘤患者MDRO感染的危险因素。 结论 恶性肿瘤患者MDRO的危险因素较多,应针对这些危险因素采取有效的防控措施,以降低MDRO感染的发生率。Abstract: Objective To investigate the infection status and risk factors of multidrug resistant bacteria(MDRO) in patients with malignant tumors in a hospital. Methods A total of 1 280 patients with malignant tumor infection admitted to a hospital from January 2014 to December 2017 were divided into MDRO infection group(n=270) and non-MDRO infection group(n=1 010). Risk factors for MDRO infection in malignant tumor patients were analyzed by univariate and multivariate logistic regression. Results The incidence of MDRO infection was 21.09%(270/1 280) in 1 280 patients with malignant tumors. A total of 295 strains of multidrug-resistant bacteria were detected in 270 patients with MDRO infection. The top three strains were Acinetobacter Baumannii(31.19%), Pseudomonas Aeruginosa(23.05%) and Escherichia coli(19.32%). Univariate and multivariate logistic regression analysis showed that long-term bedridden(OR=2.804, 95% CI:1.725-4.364), invasive operation(OR=3.907, 95% CI:2.914-7.523), types of antibiotics used(OR=5.306, 95% CI:4.105-9.248), time spent using antibiotics(OR=3.117, 95% CI:2.208-6.731) and low albumin level(OR=2.105, 95% CI:1.286-3.740) were risk factors for MDRO infection in patients with malignant tumors. Conclusion There are many risk factors for MDRO in patients with malignant tumors. Effective prevention and control measures should be taken against these risk factors to reduce the incidence of MDRO infection.
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Key words:
- Malignant tumors /
- Multidrug-resistant bacteria /
- Nosocomial infection /
- Risk factors
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