摘要
目的探讨恶性肿瘤患者耐碳青霉烯肠杆菌(CRE)感染的危险因素,并分析其耐药性,为院内感染防治提供依据。方法回顾性分析2014年1月至2018年12月共82例CRE感染的恶性肿瘤患者资料,对耐药性进行分析,并选取同期165例碳青霉烯敏感肠杆菌感染恶性肿瘤患者作为对照组,通过logistic回归分析探讨感染的危险因素。结果所有恶性肿瘤CRE患者对头孢吡肟、阿莫西林/克拉维酸耐药率高(均>90%),而其中肺炎克雷伯菌对头孢曲松、头孢他啶耐药率高(均>90%),大肠埃希菌对头孢曲松耐药率高(93.1%);CRE对替加环素敏感性高(其中肺炎克雷伯菌为92.7%,余为100%),CRE中大肠埃希菌对阿米卡星也有较好敏感性(72.4%)。Logistic多因素回归分析显示既往使用碳青霉烯类抗生素患者是CRE感染的独立危险因素。结论恶性肿瘤CRE患者耐药率高,对替加环素敏感性好,年龄≥60岁、进行化疗、合并糖尿病、既往使用碳青霉烯类抗生素是CRE感染的危险因素,既往使用碳青霉烯类抗生素是恶性肿瘤患者CRE感染的独立危险因素,院感部门应有针对性的加强防控。
Objective To explore the risk factors and drug resistance of Carbapenem-resistant Enterobacter(CRE)in malignant tumor patients to provide a basis for the prevention and treatment of hospital infection.Methods A retrospective analysis of 82 malignant tumors patients infected with CRE from January 2014 to December 2018 was conducted and the drug resistance was also analyzed.Besides,165 cases of malignant tumors patients sensitive to CRE infection were selected as the control group.Then,logistic regression analysis was carried out to investigate infection risk factors.Results All patients with CRE showed a high drug resistance to cefepime and amoxicillin/clavulanic acid(>90%),and klebsiella pneumoniae had a high drug resistance to ceftriaxone and ceftazidime(>90%).And,Escherichia coli showed a high drug resistance to ceftriaxone(93.1%).In addition,CRE was highly sensitive to tigecycline,among which Klebsiella pneumoniae was 92.7%and the rest was 100%.Escherichia coli in CRE also had a good sensitivity to amikacin(72.4%).Logistic multiple-factor regression analysis indicated that previous use of carbapeem antibiotics was the independent risk factor for patients infected with CRE.Conclusion CRE patients with malignant tumors have a good sensitivity to tigecycline and a high drug resistance rate.Age(great than or equal to 60 years old),chemotherapy,combined diabetes and previous use of carbapeem antibiotics are the risk factors for CRE infection.A previous use of carbapeem antibiotics is the independent risk factor for the CRE infection of malignant tumors patients.Therefore,the department of hospital infection should purposefully strength prevention and control.
作者
尹海庆
姚宝国
陈万贞
苏莉
Yin Haiqing;Yao Baoguo;Chen Wanzhen;Su Li(Department of Oncology,Henan Honliv Hospital,Xinxiang 453400,China;Department of Laboratory Medicine,Henan Honliv Hospital,Xinxiang 453400,China;Department of Thyroid Breast Surery,Ningxia People's Hospital,Yinchuan 750021,China;Department of Oncology,Ningxia People's Hospital,Yinchuan 750021,China)
出处
《临床荟萃》
CAS
2020年第2期166-169,共4页
Clinical Focus
基金
宁夏自然科学基金——浆细胞性乳腺炎与IgG4-RD相关性研究及CTLA-4基因表达的研究(NZ17192)
关键词
肠杆菌科感染
耐碳青霉烯类
耐药性
危险因素
enterobacteriaceae infections
carbapenem-resistant
drug resistance
risk factors
作者简介
通信作者:苏莉,Email:sl1105199@sina.com。
