肺炎克雷伯菌血流感染耐药及死亡的危险因素分析
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Analysis of risk factors of drug resistance and death of Klebsiella pneumoniae bloodstream infection
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    摘要:

    目的:探索碳氢霉烯类耐药肺炎克雷伯菌(CRKP)血流感染的危险因素及肺炎克雷伯菌血流感染患者的死亡危险因素-方法:回顾性分析2009年1月—2014年12月南京医科大学第二附属医院住院的91例肺炎克雷伯菌血流感染患者的病例资料-通过卡方检验等方法确定CRKP产生的危险因素,通过Logistic回归确定肺炎克雷伯菌血流感染死亡的危险因素-结果:CRKP组血流感染患者合并肺炎(P=0.016)-有创机械通气(P=0.048)及入住ICU(P=0.017)的比例明显高于SKP组及ESBLKP组-单因素Logistic回归分析发现WIC评分≥3分-恶性肿瘤-肾功能不全-低蛋白血症-深静脉置管-有创机械通气-入住ICU -Pitt菌血症评分≥6分是肺炎克雷伯菌血流感染患者的死亡危险因素-多因素Logistic回归分析发现Pitt菌血症评分≥6分(OR=509.891,P < 0.001)是肺炎克雷伯菌血流感染患者死亡的独立危险因素-结论:患者合并肺炎-进行有创机械通气及入住ICU是产生CRKP血流感染的危险因素;Pitt菌血症评分≥6分是肺炎克雷伯菌血流感染患者死亡的独立危险因素-

    Abstract:

    Objective:To explore the risk factors of bloodstream infection in patients with hydrocarbon resistant Klebsiella pneumoniae(CRKP)and the risk factors of death in patients with Klebsiella pneumoniae bloodstream infection. Methods:Clinical data from 91 patients with Klebsiella pneumonia bloodstream infection were analyzed in the Second Affiliated Hospital of Nanjing Medical University from December 2009 to January 2014. The risk factors of CRKP were determined by the chi square test,and the risk factors for the death of Klebsiella pneumoniae bloodstream infection were determined by Logistic regression. Results:Im CRKP group,proportion of bloodstream infectied patients complicated by pneumonia(P=0.016),invasive mechanical ventilation(P=0.048)and ICU(P=0.017) was significantly higher than that im the SKP group and ESBLKP group. Univariate logistic regression analysis showed that WIC score≥3,malignant tumor,renal function imsufficiency,hypoproteinemia,deep vein set tube,with invasive mechanical ventilation,ICU admission,Pitt bacteremia score≥6 were the risk factors of death in patients with Klebsiella pneumoniae bloodstream infection. Multivariate logistic regression analysis showed that Pitt bacteremia score≥6 points(OR=509.891,P < 0.001)was an independent risk factor of patients died of Klebsiella pneumoniae bloodstream infection. Conclusion:With pneumonia,invasive mechanical ventilation and ICU stay were risk factors for CRKP-producing bloodstream infection;Pitt bacteremia score≥6 was the independent risk factor of patients died of Klebsiella pneumoniae bloodstream infection.

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马李平,冯旰珠,杜兴冉.肺炎克雷伯菌血流感染耐药及死亡的危险因素分析[J].南京医科大学学报(自然科学版),2016,(12):1466-1470

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  • 收稿日期:2016-06-23
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  • 在线发布日期: 2016-12-28
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