重症监护室肺炎克雷伯菌医院感染的临床危险因素分析

摘要

Objective To study the prevalence, common site , risk factors, and independent risk factors for nosocomial Klebsiella pneumoniae infection in aiming to determine the preventive and therapeutic regimens and measures. Methods Seventy-seven patients complicated with nosocomial Klehsiella pneumoniae infection hospitalized from January 2002 to December 2006 ( study group ) were retrospectively reviewed whilst matched patients with Escherichia coli infection ( n = 35 ) were simultaneously included as control group to identifv the risk factors of nosocomial Klehsiella pneumoniae infection. Results Single factor analysis showed that the use of steroids,coma or brain injury, and mechanical ventilation were the risk factors of nosocomial Klehsiella pneumoniae infertion. The multifactorial analysis identified the use of steroids and mechanical ventilation as the independent risk factors. Conclusions The use of steroids and mechanical ventilation are independent risk factors of nosocomial Klebsiella pneumoniae infection, requiring specific control measures.%目的探讨重症监护病房(ICU)肺炎克雷伯菌医院感染的发病率、常见感染部位、危险因素、独立危险因素,为制订医院感染的防治策略、措施提供依据.方法调查2002年1月至2006年12月77例肺炎克雷伯菌医院感染患者(病例组),选取同一科室与病例组同期住院的35例发生大肠埃希菌医院感染的患者作为对照组,分析肺炎克雷伯菌医院感染的危险因素.结果单因素分析结果显示,激素的使用、昏迷或颅脑损伤、机械通气是肺炎克雷伯菌致医院感染的危险因素.多因素分析结果显示,肺炎克雷伯菌医院感染的独立危险因素是使用激素、机械通气.结论激素使用、机械通气是肺炎克雷伯菌医院感染的独立危险因素,应针对肺炎克雷伯菌医院感染的危险因素采取措施,控制医院感染.