摘要
Abstract
Objective The risk factors of ultra-broad spectrum β-lactamase production of Escherichia coli and Klebsiella pneumoniae were analyzed,and the clinical characteristics were summarized to provide reference for effective prevention and control of nosocomial cross-infection dedication.Methods The clinical data of 167 patients of nosocomial infection with non-repetitive Escherichia coli and Klebsiella pneumoniae received by the Longyan First Hospital Affiliated to Fujian Medical University from March 2022 to February 2023 were retrospectively analyzed,urine samples were collected for bacterial culture,and strain identification and drug susceptibility test were conducted.A case-control study was used to group according to whether the ultra-broad spectrum β-lactamase was produced,and patients with producing the enzyme were included in the case group,and patients without producing the enzyme were included in the control group.Patient clinical characteristics were analyzed by statistical methods,and infection risk factors were analyzed by multivariate regression analysis.Results Among 167 patients,105 Escherichia coli and 62 Klebsiella pneumoniae were isolated,while 30 Klebsiella pneumoniae produced ultra-broad spectrum β-lactamase and 77 Escherichia coli produced ultra-broad spectrum β-lactamase.Patients with Klebsiella pneumoniae and ultra-broad spectrum β-lactamase production from Escherichia coli showed higher resistance to ceffuroxime,cefoperazone sodium sulbactam sodium,moxifloxacin,gentamicin,and piperacillin than did patients with no ultra-broad spectrum β-lactamase bacteria,with statistically significant differences(P<0.05).Univariate analysis showed that the proportion of penicillin,the proportion of hypoproteinemia,the proportion of third-generation cephalosporin and the use of deep venous catheterization were higher than that of the control group(P<0.05).Logistic Multivariate regression analysis showed that the drug history of hypoproteinemia and third-generation cephalosporins increased the risk of ultra-broad-spectrum β-lactamase production in patients with Escherichia coli and Klebsiella pneumoniae infection,with statistically significant differences(P<0.05).Conclusion Drug history and hypoproteinemia of third-generation cephalosporins will increase the risk of ultra-broad spectrum β-lactamase production of Escherichia coli and Klebsiella pneumoniae.Emphasis should be placed on monitoring high-risk groups to reduce the use of cephalosporins and penicillin drugs and control the risk of infection.关键词
超广谱β-内酰胺酶/大肠埃希菌/肺炎克雷伯菌/感染/危险因素Key words
Extended-spectrum β-lactamases/Escherichia coli/Klebsiella pneumoniae/Infection/Risk factors分类
医药卫生
