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目的 探讨医院内产生超广谱 β 内酰胺酶 (ESBLs)细菌感染的危险因素。 方法 收集浙江省 1 999年 5月至 2 0 0 0年 5月 6所医院收治的 1 85例ESBLs阳性细菌医院内感染病例 ,男 1 0 8例 ,女 77例 ;平均年龄 (55± 1 7)岁 ;1 85例中呼吸道感染 59例 ,泌尿道感染 71例 ,血液感染 1 0例 ,创口感染 30例 ,其他部位感染 1 5例。同时选取 77例ESBLs阴性细菌医院内感染者为对照 ,男 54例 ,女 2 3例 ,平均年龄 (54± 2 0 )岁。其中呼吸道感染 38例 ,泌尿道感染 2 0例 ,血液感染 6例 ,创口感染 8例 ,其他部位感染 5例。对两组病人的危险因素进行病例对照研究 ,采用非条件logistic回归分析和主成分分析进行研究。结果 多因素非条件logistic回归分析结果表明 ,三代头孢菌素应用 3d以上 (OR =4 52 ,95 %CI为 2 30～ 8 89)、联合应用抗生素 (OR =2 86 ,95 %CI为 1 51～ 5 43)、喹诺酮类抗生素使用 3d以上 (OR =2 44,95 %CI为 1 1 8～ 5 0 4 )、应用肾上腺皮质激素 (OR =2 1 6 ,95 %CI为 1 0 8～4 31 )及给氧 (OR =2 56 ,95 %CI为 1 1 4～ 5 72 )是产生ESBLs的细菌医院内感染的独立危险因素 ;从1 4个产生ESBLs的细菌医院内感染危险因素中提取了 5个主成分进行分析 ,其方差累积贡献率达60 2 %。 5个主成分?
Objective To explore the risk factors of bacterial infection in extended-spectrum β-lactamases (ESBLs) in hospitals. Methods A total of 1 85 cases of nosocomial infection of ESBLs positive bacteria were collected from 6 hospitals in Zhejiang Province from May 1999 to May 2000, including 108 males and 77 females, with an average age of 55 ± 1 7 ). Of the 85 cases, 59 were respiratory infections, 71 were urinary tract infections, 10 were blood infections, 30 were wound infections and 15 were other parts of the infection. At the same time, 77 patients with ESBLs-negative bacterium were selected as controls, including 54 males and 23 females, with an average age of (54 ± 20) years. Among them, 38 were respiratory tract infections, 20 urinary tract infections, 6 blood infections, 8 wound infections and 5 other infections. A case-control study was conducted on the risk factors of two groups of patients, using non-conditional logistic regression analysis and principal component analysis. Results The results of multivariate non-conditional logistic regression analysis showed that the third generation cephalosporins were applied more than 3d (OR = 4 52, 95% CI 2 30 ~ 8 89) and combined antibiotics (OR = 286, 95% CI 1 51 ~ 433). The quinolone antibiotics used more than 3d (OR = 244,95%, CI = 118 ~ 504), and adrenocorticotropic hormone (OR = 216, 95% CI: 31) and oxygenation (OR = 2,556, 95% CI, 11 4 ~ 5 72) were independent risk factors for nosocomial infections of ESBLs-producing bacteria; from among nosocomial infection risk factors of 14 ESBLs-producing bacteria The five principal components were analyzed, and the cumulative contribution rate of variance was 60 2%. 5 main components?