Lavagnoli Lilian Silva, Bassetti Bil Randerson, Kaiser Thais Dias Lemos, Kutz Kátia Maria, Cerutti Crispim
MSc, Microbiologist, Laboratório de Microbiologia Médica, Secretaria de Saúde, Vitória, ES, Brazil.
Physician, Hospital Estadual Central, Vitória, ES, Brazil. Physician, Hospital Santa Casa de Misericóridia de Vitória, Vitória, ES, Brazil.
Rev Lat Am Enfermagem. 2017 Oct 5;25:e2935. doi: 10.1590/1518-8345.1751.2935.
to identify possible risk factors for acquisition of Enterobacterial strains with a marker for resistance to carbapenems.
exploratory case-control study performed in hospital settings. The study sample consisted of patients with biological specimens that tested positive for carbapenem-resistant Enterobacteriaceae (cases), with the disk diffusion test and Etest, and controls with biological samples testing negative for carbapenem-resistant Enterobacteriaceae. In all, 65 patients were included: 13 (20%) cases and 52 (80%) controls.
the microorganisms isolated were Serratia marcescens (6), Klebsiella pneumoniae (4), and Enterobacter cloacae (3). Univariate analysis revealed that length of hospitalization prior to sample collection (p=0.002) and having a surgical procedure (p=0.006) were statistically significant. In the multivariable logistic regression model, both were still significant, with odds ratios of 0.93 (p = 0.009; 95% CI: 0.89 to 0.98) for length of hospitalization prior to sample collection, and 9.28 (p = 0.05; 95% CI: 1.01 to 85.14) for having a surgical procedure.
shorter hospitalization times and increased surveillance of patients undergoing surgery could play a decisive role in reducing the spread of carbapenem-resistant microorganisms in hospital settings.
确定获得带有碳青霉烯类耐药标记的肠杆菌菌株的可能风险因素。
在医院环境中进行探索性病例对照研究。研究样本包括碳青霉烯类耐药肠杆菌科细菌检测呈阳性的患者（病例组），采用纸片扩散法和Etest检测，以及碳青霉烯类耐药肠杆菌科细菌检测呈阴性的生物样本对照。总共纳入65例患者：13例（20%）病例组和52例（80%）对照组。
分离出的微生物有粘质沙雷氏菌（6株）、肺炎克雷伯菌（4株）和阴沟肠杆菌（3株）。单因素分析显示，样本采集前的住院时间（p=0.002）和进行外科手术（p=0.006）具有统计学意义。在多变量逻辑回归模型中，两者仍然具有显著性，样本采集前的住院时间的比值比为0.93（p = 0.009；95%置信区间：0.89至0.98），进行外科手术的比值比为9.28（p = 0.05；95%置信区间：1.01至85.14）。
缩短住院时间以及加强对接受手术患者的监测可能在减少医院环境中碳青霉烯类耐药微生物的传播方面发挥决定性作用。
