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实体瘤患者中耐多药细菌引起感染的危险因素。

Risk factors for infections caused by multidrug-resistant bacteria in patients with solid tumours.

作者信息

Horasan Elif Sahin, Ersoz Gulden, Horoz Mehmet, Göksu Musa, Karacorlu Sevim, Kaya Ali

机构信息

Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Mersin University, 33079 Mersin, Turkey.

出版信息

Scand J Infect Dis. 2011 Feb;43(2):107-11. doi: 10.3109/00365548.2010.534500. Epub 2010 Nov 16.

Abstract

OBJECTIVES

We aimed to determine the risk factors for healthcare-associated infections (HCAI) caused by multidrug-resistant (MDR) bacteria in patients with solid tumours.

METHODS

This retrospective study was performed in the Department of Clinical Microbiology and Infectious Diseases, Mersin Teaching and Research Medical Centre, between January 2004 and December 2008. SPSS version 11.5 program package was used for the statistical analyses.

RESULTS

A total of 145 patients who had an HCAI were analyzed; 62% of the patients were male and their median age was 57.7 ± 16 y and median Charlson co-morbidity score was 4.94 ± 1.2. During the study period, 83 MDR bacteria were isolated from HCAIs that developed in 70 (48.3%) patients. In multiple binary logistic regression analysis, duration of hospital stay (odds ratio (OR) 1.041, 95% confidence interval (CI) 1.007-1.077; p = 0.019), surgery (OR 3.115, 95% CI 1.288-7.535; p = 0.012), use of glycopeptides (OR 5.394, 95% CI 1.960-14.850; p = 0.001), and use of third-generation cephalosporins (OR 5.521, 95% CI 2.017-15.110; p = 0.001) were found to be independent risk factors for the development of an MDR infection.

CONCLUSIONS

Among hospitalized patients with a solid tumour, HCAIs caused by MDR bacteria occurred more frequently in patients undergoing surgery, receiving third-generation cephalosporins and glycopeptide antibiotics, and having a prolonged hospital stay.

摘要

目的

我们旨在确定实体瘤患者中由多重耐药(MDR)菌引起的医疗保健相关感染(HCAI)的危险因素。

方法

这项回顾性研究于2004年1月至2008年12月在梅尔辛教学与研究医学中心临床微生物学与传染病科进行。使用SPSS 11.5版程序包进行统计分析。

结果

共分析了145例发生HCAI的患者;62%的患者为男性,中位年龄为57.7±16岁,中位查尔森合并症评分是4.94±1.2。在研究期间,从70例(48.3%)患者发生的HCAI中分离出83株MDR菌。在多重二元逻辑回归分析中,住院时间(比值比(OR)1.041,95%置信区间(CI)1.007 - 1.077;p = 0.019)、手术(OR 3.115,95%CI 1.288 - 7.535;p = 0.012)、糖肽类药物的使用(OR 5.394,95%CI 1.960 - 14.850;p = 0.001)以及第三代头孢菌素的使用(OR 5.521,95%CI 2.017 - 15.110;p = 0.001)被发现是发生MDR感染的独立危险因素。

结论

在住院实体瘤患者中,由MDR菌引起的HCAI在接受手术、使用第三代头孢菌素和糖肽类抗生素以及住院时间延长的患者中更频繁发生。

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