摘要
目的:分析住院成年人感染耐碳青霉烯类肺炎克雷伯菌(CRKP)的危险因素和预后因素。方法:2016年1月到2018年1月在武汉大学中南医院和湖北省阳新县人民医院进行一项回顾性病例对照研究,其中病例组与对照组入组例数为1∶2,对照组是碳青霉烯类敏感的肺炎克雷伯菌(CSKP),以确定CRKP感染的危险因素、死亡率和预后因素,并且通过单变量和多变量逻辑回归分析来评估CRKP感染相关的危险因素和预后因素。结果:多变量分析显示中心静脉导管插入术(CVC)(P=0.031)、使用碳青霉烯类抗生素(P=0.003)、头孢哌酮/舒巴坦(P=0.001)或氟喹诺酮(P=0.010)是CRKP感染的独立危险因素。CRKP组死亡率(28.0%)显著高于CSKP组(11.3%,P=0.001)。肺部疾病(P=0.040)、CVC(P=0.002)、留置胃管(P<0.001)和淋巴细胞绝对值减少(P=0.012)是死亡率较高的预测因子。结论:以上结果对于针对降低CRKP感染住院患者的死亡率制定预防措施具有价值。
Objective: To analyze the risk factors and prognostic factors of carbapenem-resistant Klebsiella pneumoniae(CRKP) in hospitalized adults. Methods: A retrospective 1∶2 case-control study was conducted at Zhongnan Hospital of Wuhan University and People’s Hospital of Yangxin County, Hubei Province from January 2016 to January 2018 to identify risk factors associated with CRKP infection,mortality and prognostic factors among adult inpatients with CRKP infection and matched adult inpatients with CSKP infection at the same site and time of isolation. Univariate and multivariate logistic regression analysis were performed to assess risk factors associated with CRKP infection and predictors of death. Results: Multivariable analysis identified central venous catheter catheterization(CVC)(P=0. 031), exposure to carbapenem(P=0. 003), cefoperazone plus sulbactam(P=0. 001), or fluoroquinolone(P=0. 010) as independent risk factors for CRKP infection. Mortality in CRKP(28. 0%)was significantly higher than that of CSKP(11. 3%) group(P=0. 001). Lung diseases(P=0. 040),CVC(P=0. 002), indwelling gastric tube(P<0. 001), and decrease in absolute lymphocyte counts(P=0. 012) were predictors for higher mortality rate. Conclusion: These findings should be of value in developing preventive measures to reduce mortality among inpatients with CRKP infection.
作者
肖唐杰
马容莉
吴开松
XIAO Tangjie;MA Rongli;WU Kaisong(Dept.of Respiratory and Critical Care Medicine,People’s Hospital of Yangxin County of Hubei Province,Huangshi 435000,Hubei,China;The Second Dept.of Cadre Ward,General Hospital of Central Theater Command of The PLA,Wuhan 430071,Hubei,China;Dept.of Respiratory and Critical Care Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2022年第5期793-797,816,共6页
Medical Journal of Wuhan University
关键词
耐碳青霉烯类肺炎克雷伯菌
死亡率
危险因素
预后因素
Carbapenem-Resistant Klebsiella Pneumoniae
Mortality
Risk Factors
Prognostic Factors
