多重耐药菌医院感染分布特征与影响因素探究OA
Epidemiological characteristics and determinants of healthcare-associated infections due to multidrug-resistant organisms
目的 分析医院感染中多重耐药菌(multidrug-resistant organisms,MDRO)的分布特征及其危险因素,为多重耐药菌医院感染预防与控制提供理论依据.方法 选取2023年1月1日至2024年12月31日庆阳市人民医院收治的545例医院感染患者为研究对象.采用病例对照研究设计,按年龄、性别、科室、入院时间进行1∶2匹配,其中经病原学证实的91例MDRO感染患者为病例组,182例非MDRO感染患者为对照组.采用卡方检验进行单因素分析,以匹配因素(年龄、性别、科室、入院时间)为分层变量,运用条件Logistic回归模型筛选独立危险因素.结果 共纳入医院感染病例为545例,其中多重耐药菌感染91例,占比为16.69%(91/545).MDRO医院感染菌株以大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、金黄色葡萄球菌等为主,感染标本以痰标本为主(37.36%),高发科室为综合ICU(25.27%).多因素分析结果显示:贫血(OR=2.803,95%CI:1.416～5.551)、抗菌药物使用种类≥3种(OR=2.397,95%CI:1.282～4.483)、肺部感染史(OR=2.569,95%CI:1.327～4.976)、入住过ICU(OR=2.436,95%CI:1.242～4.779)与医院MDRO感染发生率增高有关(P＜0.05).结论 三甲医院MDRO感染以革兰氏阴性菌为主,综合ICU为高发区域,贫血、多类抗菌药物使用、肺部感染史及ICU入住史是核心风险因子,需针对性制定分层防控策略,从而有效降低院内MDRO感染发生率.
Objective To analyze the distribution characteristics and risk factors of multidrug-resistant organisms(MDRO)in hospital infections,and to provide a theoretical basis for the prevention and control of MDRO hospital infections.Method A total of 545 patients with hospital-acquired infections in Qingyang People's Hospital from January 1,2023 to December 31,2024 were selected as the research subjects.Among them,91 patients with MDRO infections confirmed by etiology were assigned to the case group.A 1:2 matched case-control study design was adopted,and 182 patients without MDRO infections were matched by age,gender,department,and admission time to form the control group.The chi-square test was used for univariate analysis,and the conditional Logistic regression model was applied to screen independent risk factors with matching factors(age,gender,department,and admission time)as stratification variables.Result A total of 545 cases of hospital-acquired infections were included,among which 91 cases were caused by multi-drug resistant bacteria,accounting for 16.69%(91/545).The main MDRO strains causing hospital-acquired infections were Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,and Staphylococcus aureus,with sputum specimens being the most common(37.36%).The high-incidence department was the comprehensive ICU(25.27%).Multivariate analysis showed that anemia(OR=2.803,95%CI:1.416-5.551),use of≥3 types of antibiotics(OR=2.397,95%CI:1.282-4.483),history of pulmonary infection(OR=2.569,95%CI:1.327-4.976),and previous ICU stay(OR=2.436,95%CI:1.242-4.779)were associated with an increased risk of MDRO hospital-acquired infections(P＜0.05).Conclusion In tertiary hospitals,MDRO infections are mainly caused by Gram-negative bacteria,with the comprehensive ICU being a high-risk area.Anemia,use of multiple types of antibiotics,history of pulmonary infection,and ICU stay are core risk factors.Stratified prevention and control strategies should be developed to effectively reduce the incidence of MDRO hospital-acquired infections.
姚程洪;段凯悦;刘变叶;全富贵;张小亮;冯玉娟;姚子琰;李淑华;张浩军
甘肃中医药大学公共卫生学院,甘肃 兰州 730000甘肃中医药大学公共卫生学院,甘肃 兰州 730000庆阳市人民医院医院感染管理科,甘肃 庆阳 745003庆阳市人民医院医院感染管理科,甘肃 庆阳 745003西北民族大学附属医院/甘肃省第二人民医院公共卫生与医院感染管理科,甘肃 兰州 730046西北民族大学附属医院/甘肃省第二人民医院公共卫生与医院感染管理科,甘肃 兰州 730046西北民族大学附属医院/甘肃省第二人民医院公共卫生与医院感染管理科,甘肃 兰州 730046西北民族大学附属医院/甘肃省第二人民医院公共卫生与医院感染管理科,甘肃 兰州 730046西北民族大学附属医院/甘肃省第二人民医院院长办公室,甘肃 兰州 730046
医药卫生
医院感染多重耐药菌病例对照研究
Hospital infectionMulti-drug resistant bacteriaCase-control study
《新发传染病电子杂志》 2026 (2)
24-29,6
1.甘肃省卫生健康行业科技创新重大项目(GSWSZD2025-14)2.中央高校基本科研业务费专项资金项目(31920240079)3.甘肃省卫生健康行业科研项目(GSWSKY2025-27)
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