【摘要】 目的:研究产超广谱β-内酰胺酶(ESBLs)肠杆菌血行感染的危险因素。方法:回顾性分析233例血培养结果示肠杆菌科类细菌生长的患者病历资料,详细记录基线资料,分析产超广谱β-内酰胺酶肠杆菌科血行感染的危险因素。结果:年龄(OR:0.935,95%CI:0.887～0.985)、APACHEⅡ评分(OR:1.408,95%CI:1.269～1.563)、感染大肠埃希菌(OR:4.274,95%CI:1.225～14.916)、侵袭性的医疗操作(OR:0.377,95%CI:0.150～0.947)以及三代头孢菌素的暴露(OR:0.254,95%CI:0.071～0.906)是产ESBLs肠杆菌血行感染的重要独立危险因素。结论:患者病情严重程度、感染状态、初始经验性抗菌治疗方案以及医疗侵袭性操作,都会使产ESBLs肠杆菌血行感染的风险增加,因此,有必要根据患者的不同病情做出合理的临床决策,并选择合适的抗菌药物。更多还原

【Abstract】 Objective: To study the risk factors for the bloodstream infection of enterobacteriaceae bacteria producing extended spectrum β-lactamases(ESBLs). Method: This retrospective study included 233 patients whose blood culture results showed that they were infected with Enterobacteriaceae bacterial. Their medical records and baseline data were recorded in detail and the risk factors for ESBLs-producing Enterobacteriaceae infection were analyzed. Result: Age(OR: 0.935, 95%CI: 0.887～0.985), APACHE-II score(OR: 1.408, 95%CI: 1.269～1.563), infection with E. coli(OR: 4.274, 95%CI: 1.225～14.916), invasive medical procedures(OR: 0.377, 95%CI: 0.150～0.947) and exposure to third-generation cephalosporins(OR: 0.254, 95%CI: 0.071～ 0.906) were important independent risk factors for ESBLs-producing enterobacteriaceae bacteria infection. Conclusion: The severity of the disease, the state of infection, the initial empirical antibacterial treatment, and the medical invasive procedure will increase the risk of infection of ESBLs-producing enterobacteriaceae bacteria. Therefore, it is necessary to make reasonable clinical decisions according to the patient’s condition,and choose the right antibacterial drug.更多还原