糖尿病患者院内多重耐药菌感染易感因素剖析.docVIP

糖尿病患者院内多重耐药菌感染易感因素剖析 　　[摘要] 目的 探讨糖尿病患者院内多重耐药菌感染，为临床防治提供科学依据。 方法 选取惠州市中心人民医院2008年1月～2012年12月糖尿病患者发生院内感染的264例进行回顾性分析，以符合多重耐药感染的120例作为病例组，非多重耐药感染的144例作为对照组， 所有病例均记录以下项目： 一般情况、糖尿病病程、基础疾病、糖化血红蛋白、空腹血糖、餐后2h血糖、并发症、侵入性操作、免疫功能、抗生素的使用、感染后的预后。全部数据输入电脑，采用统计软件SPSS17.0进行汇总分析。 结果 5年来糖尿病患者院内感染、院内多重耐药菌的发病率逐年上升，以多重耐药感染上升的速度最快。以呼吸道感染最多，最常见的病原菌为革兰阴性菌（54.8%，136/248）。年龄、住院时间、ICU病房、空腹血糖、餐后2h血糖、糖化血红蛋白、昏迷、感染前30d使用抗生素、联用抗生素是多重耐药感染的易感因素。感染后30d内的死亡率高于对照组（P0.05）。 结论 糖尿病患者院内多重耐药菌的感染十分严重，与多种因素有关，预后不良，应针对易感因素采取综合性的防治措施。 　　[关键词] 糖尿病；院内感染；多重耐药；易感因素 　　[中图分类号] R197.3 [文献标识码] A [文章编号] 2095-0616（2014）13-09-04 　　[Abstract] Objective To explore hospital-acquired infections with multiple drug-resistant bacteria for patients with diabetes，and provide scientific evidence for clinical prevention and treatment. Methods 264 patients with diabetes who had hospital-acquired infections in Huizhou Municipal Central Hospital from January 2008 to December 2012 were selected and analyzed retrospectively.120 patients who accorded with multiple drug-resistant infections were allocated to an experimental group，and 144 patients without multiple drug-resistant infections were allocated to a control group.Following items were recorded in all patients：general conditions，courses of diabetes，underlying diseases，glycosylated hemoglobin， fasting blood glucose，2-hour postprandial blood glucose，complications，invasive procedure，immune function， use of antibiotics，and prognosis of infections.All data were recorded in computers，and a pooled analysis was carried out via statistical software SPSS 17.0. Results Incidence of hospital-acquired infections with multiple drug-resistant bacteria for patients with diabetes increased year by year in recent five years.Incidence of multiple drug-resistant infections increased in the fastest fashion. The most commonly seen one was respiratory tract infection，and the most commonly seen pathogen was gram-negative bacteria（54.8%，136/248）.Predisposing factors of multiple drug-resistant infections