重症监护病房多重耐药菌感染患者疾病谱分析

Disease spectrum of patients with multidrug-resistant organism infection in intensive care unit

摘要:

目的 了解重症监护病房(ICU)多重耐药菌(MDRO)感染患者的感染现状及疾病谱分布情况, 为MDRO感染防控提供依据。 方法 分析某三甲医院2018年1月-2020年12月ICU住院患者资料, 比较ICU感染MDRO者(病例组)、ICU非MDRO感染患者(对照组), 以及非ICU感染MDRO者疾病谱等差异。 结果 ICU MDRO感染患者总体构成呈上升趋势; 感染患者以男性居多, 其中大多数为老年人, MDRO感染患者较未感染患者死亡比例更高。直接入住ICU感染MDRO者在整个MDRO感染群体中占比最高。ICU MDRO感染患者检出菌株以鲍曼不动杆菌居首位, 非ICU MDRO感染患者检出菌株以大肠埃希菌居首位; 前两组患者的疾病谱相似, 以呼吸系统疾病居第一位, 其中又以肺部感染为主; ICU非MDRO感染患者疾病谱以高血压居首位, 与感染患者存在差异。不同疾病的顺位随着年份增长也有不同程度的变化。 结论 MDRO感染患者疾病谱复杂多样, 应做到科学、精准、规范治疗, 注意呼吸系统疾病的治疗, 同时强化感染预防措施的落实。

Abstract:

Objective To understand the infection status and disease spectrum distribution of patients with multidrug-resistant organism (MDRO) infection in an intensive care unit (ICU), and provide basis for the prevention and control of MDRO infection. Methods Clinical data of patients in the ICU of a tertiary first-class hospital from January 2018 to December 2020 were analyzed, differences in disease spectrum of patients with MDRO infection in ICU (case group), patients without MDRO infection in ICU (control group), and patients with MDRO infection in non-ICU were compared. Results The overall constituent of patients with MDRO infection in ICU showed an upward trend; the majority of infected patients were male, most of whom were the elderly, mortality of MDRO-infected patients was higher than that of uninfected patients. MDRO-infected patients directly admitted to ICU accounted for the highest proportion in the whole MDRO-infected patients. Acinetobacter baumannii ranked first among strains isolated from MDRO-infected patients in ICU, Escherichia coli ranked first among strains isolated from MDRO-infected patients in non-ICU; the disease spectrum of the first two groups was similar, with respiratory diseases ranking first, mainly pulmonary infection; the disease spectrum of patients without MDRO infection in ICU was hypertension, which was different from that of infected patients. The order of different diseases also changed in varying degrees with the increase of years. Conclusion The disease spectrum of patients with MDRO infection is complex and diverse, scientific, accurate and standardized treatment should be achieved, treatment of respiratory diseases should be paid attention, and the implementation of infection prevention measures should be strengthened.