专业护理机构长期居住者中抗生素耐药性感染的发生率。
Incidence of antibiotic-resistant infection in long-term residents of skilled nursing facilities.
作者信息
Rogers Mary A M, Mody Lona, Chenoweth Carol, Kaufman Samuel R, Saint Sanjay
机构信息
Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109-0429, USA.
出版信息
Am J Infect Control. 2008 Sep;36(7):472-5. doi: 10.1016/j.ajic.2007.10.016.
BACKGROUND
Information regarding the incidence of antibiotic-resistant infection in residents of skilled nursing facilities is lacking.
METHODS
The incidence and predictors of antibiotic-resistant infection were investigated in 56,182 long-term residents of 3314 skilled nursing facilities in California, Florida, Michigan, New York, and Texas.
RESULTS
The annual incidence was 12.7 cases per 1000 long-term residents overall, which varied by state (highest incidence, New York) and type of admitting facility (highest incidence, rehabilitation hospital). The incidence was greater in younger residents, males, and residents with paraplegia, quadriplegia, peripheral vascular disease, or diabetes mellitus. Dialysis, urinary catheterization, feeding tubes, tracheostomy, and use of intravenous medications were associated with elevated risk. Adjusted odds ratios (ORs) were greatest in residents with paraplegia (OR = 2.86; 95% confidence interval [CI] = 1.67 to 4.89) and those receiving dialysis (OR = 2.84; 95% CI = 1.84 to 4.37).
CONCLUSION
There is significant variation in the risk of antibiotic-resistant infection by admitting diagnosis, device use, and facility characteristics.
背景
缺乏有关专业护理机构居民抗生素耐药性感染发生率的信息。
方法
对加利福尼亚州、佛罗里达州、密歇根州、纽约州和得克萨斯州3314家专业护理机构的56182名长期居民的抗生素耐药性感染发生率及预测因素进行了调查。
结果
总体上，每1000名长期居民的年发生率为12.7例，因州而异（发生率最高的是纽约州），也因收治机构类型而异（发生率最高的是康复医院）。年轻居民、男性以及患有截瘫、四肢瘫痪、外周血管疾病或糖尿病的居民发生率更高。透析、导尿、鼻饲管、气管切开术以及静脉用药与感染风险升高相关。调整后的比值比（OR）在截瘫居民中最高（OR = 2.86；95%置信区间[CI] = 1.67至4.89），在接受透析的居民中也较高（OR = 2.84；95% CI = 1.84至4.37）。
结论
因收治诊断、器械使用和机构特征不同，抗生素耐药性感染风险存在显著差异。
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