摘要
目的分析重症监护病房(ICU)多重耐药菌感染患者风险因素的网状路径及预防对策,为临床治疗提供依据。方法回顾性分析2020年1~12月深圳市龙华区人民医院120例ICU住院感染患者的临床资料。根据是否发生多重耐药菌感染分为感染组44例和非感染组76例。采用单因素分析对两组患者多重耐药菌感染的风险因素进行筛查,并利用网络路径对上述风险因素进行分析。结果感染组患者的年龄、住院时间、住ICU时间、发热天数、实验室检查异常数、抗菌药使用天数、术后使用抗菌药天数、医疗器械使用天数明显高(长)于非感染组,差异均具有统计学意义(P<0.05);感染组患者的风险网络图显示:降钙素原异常次数、发热天数、术后抗菌药天数、年龄位于风险网络图中心位置,节点值和节点关系均为100.00,成对指数为1.13是多重耐药菌感染的关键、核心风险因素,具有较大的风险性和较强的影响力;非感染患者的风险网络图显示:心血管系统手术、尿常规异常次数、抗菌药使用天数处于风险网络图的核心位置,但节点值、节点关系及成对指数均低于多重耐药菌感染组,且整体网络图相对较松散。结论术后合理使用抗菌药,将病区内高龄、发热、降钙素原指标异常的患者作为多重耐药菌感染的高危人群,重点关注,实现预防关口前移。
Objective To analyze the risk factors of patients with multidrug-resistant bacteria infection in intensive care unit(ICU)and the preventive measures,so as to provide basis for clinical treatment.Methods The clinical data of 120 ICU patients with infection in People's Hospital of Longhua District of Shenzhen from January 2020 to December 2020 were retrospectively analyzed.According to the occurrence of multidrug-resistant bacteria infection,they were divided into infection group(44 cases)and non-infection group(76 cases).Single factor analysis was used to screen the risk factors of multidrug-resistant bacteria infection in the two groups,and the network path was used to analyze the above risk factors.Results The age,length of hospital stay,ICU stay,fever days,abnormal number of laboratory examination,antibacterial drug use days,postoperative antibacterial drug use days,and medical device use days of the infection group were significantly higher than those of the non-infection group(P<0.05).The risk network diagram of infection group showed that the number of abnormal procalcitonin,days of fever,days of postoperative antibiotics and age were in the center of the risk network diagram,the node value and node relationship were all 100.00,and the pairing index was 1.13,which were the key and core risk factors of multidrug-resistant bacteria infection,with greater risk and strong influence.The risk network diagram of non-infection group showed that cardiovascular system surgery,the number of abnormal urine routine,and the days of antibiotic use were at the core of the risk network diagram,but the node value,node relationship and pairing index were lower than those in infection group,and the overall network diagram was relatively loose.Conclusion The patients with advanced age,fever,and abnormal procalcitonin index in the ward should be regarded as the high-risk group of multidrug-resistant bacteria infection,which should be paid attention to.
作者
罗秋平
韦爱平
洪凌
LUO Qiu-ping;WEI Ai-ping;HONG Ling(Department of Medical Laboratory,People's Hospital of Longhua District of Shenzhen,Shenzhen 518109,Guangdong,CHINA)
出处
《海南医学》
CAS
2021年第14期1802-1805,共4页
Hainan Medical Journal
基金
广东省深圳市龙华区医疗卫生机构区级科研项目(编号:2020031)。
关键词
重症监护病房
多重耐药菌
网状路径
医院感染
预防对策
Intensive care unit
Multidrug resistant bacteria
Network pathway
Nosocomial infection
Preventive measures
