| ObjectiveTo analyze the clinical features and related risk factors of hospital acquired multidrug-resistant organism in the ICU(intensive care unit)of Liangshan County People’s Hospital,and to provide support for early identification,timely diagnosis and treatment,and effective prevention of MDRO(multidrug-resistant organism)infection in clinical work.MethodsAnalysis was made on the patients with nosocomial bacterial infection hospitalized in the ICU of Liangshan County People’s Hospital from January 2016 to June 2022.The patients were divided into MDRO group and sensitive group depend on the results of microbial culture identification and drug sensitivity test.We use the hospital electronic medical record system to gather the information of patients,such as gender,age,laboratory examination indicators,mechanical ventilation,antibiotic using history and other information.At the same time,analyzing the types of bacterial infection and bacterial distribution of patients,as well as the related risk factors of multidrug-resistant organism infection.Results1.Clinical data: A total of 214 patients were included,including 74 patients in the sensitive bacteria group and 140 patients in the MDRO group,accounting for about65.421%.Most of them were male.The main causes of admission were nervous system diseases(52/140,37.143%)and trauma(40/140,28.571%).Most patients with MDRO infection were accompanied by basic diseases(87.143%)and disturbance of consciousness(93.571%).Multiple infection indicators were significantly increased,such as 77.857% of patients with WBC(white blood cell),93.571% of patients with CRP(C-reactive),and all patients with PCT(procalcitonin)were increased.In addition,patients used more kinds of antibiotics(up to 5 kinds)before they were infected with multidrug-resistant organism,and most of them were given invasive operations such as tracheal intubation(95.143%),mechanical ventilation(95.714%),indwelling gastric tube(100%)and urinary tube(100%).2.Type and distribution of strains: In MDRO group,patients were mainly infected by gram-negative bacteria,such as Acinetobacter baumannii(52.857%),Klebsiella pneumoniae(13.571%).Pseudomonas aeruginosa(6.429%)and Enterobacteriaceae(3.571%),and the rest were infected by staphylococcus(4.286%),mixed bacteria(17.143%)and other infections(2.143%).MDRO infection mainly came from the lungs(92.143%),2.857% from other systems(such as urinary system,abdominal cavity,soft tissue and intracranial),and 5.000% from mixed sites.3.Risk factor analysis: Univariate analysis showed that there were statistically significant differences(P<0.05)between the two groups in terms of basic disease,HB(hemoglobin),PCT,CRP,types of antibiotic,tracheotomy time,mechanical ventilation time and time of vasoactive drug use.Multivariate logistic regression analysis showed that the underlying diseases(β=1.229、OR=3.419、95%CI=1.494-7.823、P=0.004<0.05),Hb(β=-0.021、OR=0.979、95%CI=0.964-0.994、P=0.008<0.05)and types of antibiotics(β=0.845、OR=2.327、95%CI=1.246-4.346、P=0.008<0.05)are independent risk factors for ICU patients with multidrug-resistant organism infection.Conclusion1.Most patients infected with MDRO in ICU are accompanied by basic diseases.Before infection,there are many invasive operations,and multiple infection indicators are significantly increased.2.Patients with basic diseases,low Hb and using more kinds of antibiotics may be independent risk factors for ICU patients with MDRO infection. |
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