实用临床医药杂志2024，Vol.28Issue(21)：33-37,5.DOI:10.7619/jcmp.20241896
耐碳青霉烯类肠杆菌目细菌定植情况与临床感染特征及危险因素分析
Analysis of colonization status,clinical infection characteristics,and risk factors for carbapenem-resistant Enterobacterales
摘要
Abstract
Objective To analyze the colonization status and clinical infection characteristics of carbapenem-resistant Enterobacterales(CRE)and to identify its risk factors.Methods From Janu-ary 2021 to January 2023,129 patients with CRE colonization admitted to our hospital were included in the colonization group,and the species identification results and departmental distribution of CRE were recorded.The sensitivity of CRE-colonized patients to commonly used antimicrobials was ana-lyzed based on the results of antimicrobial susceptibility testing.Additionally,80 patients with car-bapenem-sensitive Enterobacterales(CSE)infections during the same period were recruited as control group.Clinical data between the colonization group and the control group were compared,and multi-variate Logistic regression analysis was conducted to screen for risk factors for CRE colonization.Results A total of 129 CRE strains were isolated from 129 patients with CRE colonization,with Klebsiella pneumoniae and Escherichia coli being the most commonly seen bacteria,accounting for 47.29％and 18.60％,respectively.The 129 CRE strains were mainly distributed in the Critical Care Medicine Department,Urological Surgery Department,and Thoracic Surgery Department,with proportions of 22.48％,16.28％,and 15.50％,respectively.The 129 common CRE strains exhibited high resistance rates to antimicrobials such as piperacillin/tazobactam and meropenem,and high sensitivity to tigecycline and polymyxin.The colonization group had a higher proportion of patients with antimicrobial use for＞2 weeks,tracheal intubation,indwelling catheters,corticosteroid use,and immunosuppressant use compared to the control group(P＜0.05).There were no statistically significant differences in gender,age,hypertension,antifungal drug use,long-term bed rest,hemo-globin,or body mass index between the two groups(P＞0.05).The results of multivariate Logistic regression analysis revealed that antimicrobial use for＞2 weeks(95％CI,1.289 to 5.407),tra-cheal intubation(95％CI,1.065 to 5.006),indwelling catheters(95％CI,1.020 to 5.129),corticosteroid use(95％CI,1.387 to 5.789),and immunosuppressant use(95％CI,1.249 to 5.492)were risk factors for CRE colonization(OR＞1,P＜0.05).Conclusion Klebsiella pneu-moniae and Escherichia coli are the most common species of CRE colonized clinically,primarily dis-tributed in the Critical Care Medicine Department,Urological Surgery Department,and Thoracic Surgery Department.CRE colonization is associated with factors such as antimicrobial use for＞2 weeks,tracheal intubation,indwelling catheters,corticosteroid use,and immunosuppressant use.Thus,enhanced protective measures for susceptible patients should be implemented clinically.关键词
耐碳青霉烯类肠杆菌目细菌/定植/临床感染特征/危险因素Key words
carbapenem-resistant Enterobacterales/colonization/characteristics of clinical infection/risk factors分类
医药卫生引用本文复制引用
张秋月,康亚丽,李建亮..耐碳青霉烯类肠杆菌目细菌定植情况与临床感染特征及危险因素分析[J].实用临床医药杂志,2024,28(21):33-37,5.基金项目
2022年度山东省医药卫生科技发展计划项目(202211000916) （202211000916）
