【摘要】 目的 探讨碳青霉烯类抗生素耐药的肠杆科细菌(CRE)感染的发生和导致患者死亡的危险因素。方法 收集我院CRE感染患者84例,同时随机抽取同期住院的碳青霉烯类抗生素敏感的肠杆科细菌(CSE)感染患者84例及非肠杆菌感染患者84例。采用病例-病例-对照研究的方法探讨CRE感染发生和患者30天死亡的危险因素。结果 CRE和CSE患者最常见的致病菌均为肺炎克雷伯杆菌和大肠杆菌。Logistic回归分析结果显示,脑血管病(OR=1.960,95%CI0.028～2.708,P=0.017)和碳青霉烯类抗生素使用(OR=2.026,95%CI 0.031～2.570,P=0.007)是CRE感染的独立危险因素;外科手术史(OR=1.753,95%CI 0.037～2.809,P=0.026)和静脉置管(OR=1.213,95%CI0.092-2.959,P=0.042)是CSE感染的独立危险因素。年龄(OR=1.187,95%CI 1.029～1.414,P=0021)、肺部感染(OR=7.081,95%CI 2.053～688.270,P=0.029)、血降钙素原(OR=2.098,95%CI 1.313～58.799,P=0.037)是CRE感染后30天死亡的独立危险因素。结论 临床医生应对导致CRE感染和死亡的危险因素加以重视。更多还原

【Abstract】 Objective To explore the risk factors for acquisition and mortality of carbapenemresistant Enterobacteriaceae( CRE) infection. Methods A total of 84 patients with CRE infections,84 patients with carbapenem-susceptible Enterobacteriaceae(CSE) infection,and 84 patients with pathogens of non-Enterobacteriaceae infection were enrolled in this study. A case-case-control design was used to explore risk factors for the acquisition and 30-day mortality of CRE infections. Results The most common pathogens were klebsiella pneumoniae and escherichia. Logistic regression analysis demonstrated cerebrovascular disease( OR = 1. 960,95% CI 0. 028-2. 708,P= 0.017) and previous use of carbapenems(OR = 2. 026,95% CI 0. 031-2. 570, P = 0. 007) were independent risk factors of CRE acquisition.Surgical operating history( OR = 1. 753, 95% CI 0. 037-2. 809, P = 0. 026) and venous cetheterization(OR=1. 213, 95% CI 0. 092-2. 959,P =0. 042) were independent risk facors of CSE. Age( OR = 1. 187,95% CI 0. 092-2. 959, P = 0.021), pneumonia( OR = 7. 081,95% CI 2. 053-688. 270, P = 0. 029) and blood procalcitonin( OR = 2. 098,95% CI 1. 313-58. 799, P = 0. 037) were independent risk factors30-day mortality of CRE infection. Conclusion Clinicians should pay high attention to the the risk factors for acquisition and mortality of carbapenem-resistant Enterobacteriaceae infection.更多还原