摘要
目的探讨无菌体液中大肠埃希菌对头孢吡肟耐药的危险因素。方法收集2012年7月至2013年8月间医院在无菌体液中分离的288株大肠埃希菌,对患者病例做回顾性病例对照分析。病例组为96株头孢吡肟耐药菌株,对照组为192株头孢吡肟敏感菌株。Logistic回归模型被用来分析大肠埃希菌对头孢吡肟耐药的独立危险因素。结果大肠埃希菌对头孢吡肟的耐药率为33.3%。产超广谱β-内酰胺酶(ESBLs)、先前使用抗生素(尤其是头孢菌素)、男性、先前住院天数≥10 d、机械通气、引流管、导尿管和静脉置管等是大肠埃希菌对头孢吡肟耐药的主要危险因素。其中,产ESBLs、先前使用抗生素、先前住院天数≥10 d和男性是其独立危险因素。结论有上述危险因素存在的患者,尤其是男性,应尽量缩短住院时间,减少侵入性操作,慎用头孢菌素类药物,以减少头孢吡肟耐药菌株的出现。
Objective To identify the risk factors for acquisition of cefepime （FEP） resistance among Escherichia coli （E. coli） isolates in sterile body fluid. Methods A total of 288 successive and non-duplicate E. coli strains isolated from sterile body fluid specimens during July 2012 to August 2013 in our department were recruited for case-control study. Ninety-six case was defined as FEP-resistant isolates while 192 cases with FEP-susceptive isolates served as control. Logistic regression was performed to evaluate the independent risk factors. Results Out of the 288 total isolates, 33.3% （96/288） were resistant to FEP. Production of extended spectrum beta-lactamases （ESBLs）, previous antibiotic use, ≥ 10 d of hospital stay before infection and male were the independent risk factors associated with FEP-resistant E. coli isolates. Other major risk factors included previous use of cephalosporins, mechanical ventilation, drainage tube, urinary or intravenous catheterization. Conclusion Patients （ especially male） with above-mentioned risk factors should be kept to a shorter hospital stay, less invasive operations and more cautious use of cephalosporins in order to control the emergence of cefepime-resistant strains.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2014年第19期2030-2033,共4页
Journal of Third Military Medical University
基金
国家临床重点专科建设项目[2010(305)]~~
关键词
头孢吡肟
大肠埃希菌
耐药
危险因素
无菌体液
cefepime
Escherichia coli
resistance
risk factors
sterile body fluid
