Yang Junlin, Chen Min, Li Lingzhu, Zha Zhuhong, Cheng Min, Yang Xi
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引用次数: 0
Abstract
Background: Analysis of detection trends, infection prognosis, and risk factors for nosocomial infections (NI) in multidrug-resistant bacteria (MDRB) can help improve infection control efforts.
Methods: Using data from inpatients of a single-centre hospital in China from 2019 to 2023, we analysed trends of detection rate of carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and methicillin-resistant Staphylococcus aureus (MRSA). The Kaplan-Meier approach was used to evaluate the survival prognosis of patients infected with resistant and sensitive KP, AB, PA, and SA strains. We used a 1:1 matched case-control study to analyse risk factors.
Results: The χ2 trend test indicated a statistically significant difference in the increasing rate of CRKP (χ2=25.481, P < 0.001). CRKP and CRAB were mainly detected in the intensive care unit (ICU) and during surgery. CRPA and MRSA were mainly detected in internal medicine. The main infection sites of MDRB NI were the respiratory and blood systems. Multiple logistic regression analysis showed that patients with tumours (OR=2.886), use of corticosteroids (OR=1.403), low albumin level (OR=0.701), antibiotic co-administration (OR=2.873), surgery (OR=3.317), indwelling gastric tube (OR=1.738), mechanical ventilation (OR=1.616), and indwelling central venous catheterisation (OR=1.778) were independent risk variables for MDRB NI (P < 0.05). A short duration of antibiotic use (OR=0.665) was a protective factor for MDRB NI (P < 0.05).
Conclusion: The high lethality of CRKP infections should not be ignored. Clinical work should focus on CRKP infections of the lower respiratory tract and blood system in the ICU and enhance oversight of the judicious use of antimicrobials.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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