Risk Factors Of Multidrug Resistant Bacteria Infections Of Hospital Acquired Lower Respiratory Tract

Objective:To investigate the risk factors of multidrug resistant bacteria(MDRB) infections of hospital acquired lower respiratory tract and provide scientific evidence for prevention and controlling strategies of MDRB infections.Methods:396 patients with hospital acquired lower respiratory tract infections and positive results(≥2)in bacteria culture in sputum for the same strains ware divided into MDRB positive group(189 patients) and MDRB negative group(207 patients) according to diagnostic criteria of MDRB infections. Pathogens and antimicrobial susceptibility test results of sputum cultures, invasive treatment measures, use of antimicrobial drugs and hormones and other factors were investigated on these patients.Several statistically significant risk factors were screened out with single factor analysis,thereafter independent risk factors of MDRB infections were determined with multivariate logistic regression analysis.Results:1.The single factor analysis results showed that smoking history(P = O.007),there is underlying disease[COPD(P=0.003), cerebrovascular disease(P<0.001) and hypertension(P=0.032)],aspiration and choking by mistake in two weeks(P<0.001),hypoproteinemia(P=0.017),indwelling catheter(P<0.001), indwelling gastric tube(P<0.001), mechanical ventilation(P<0.001), endotracheal intubation(P=0.002),the deep venipuncture and catheterization(P<0.001) and the use of broad-spectrum antibiotics in nearly three months(P=0.001) are related to the occurrence of MDRB infections(P <0.05);2.The multivariable logistic analysis results of MDRB infections’ related factors identified suffering from cerebrovascular disease(OR:3.456,95%CI:2.048-5.832), the use of broad-spectrum antibiotics in nearly three months(OR:2.179,95%CI:1.074-4.423)and part of the invasive operation[the deep venipuncture and catheterization(OR:2.014,95%CI:1.150-3.529),indwelling gastric tube(OR: 1.912,95%CI:1.123-3.532),mechanical ventilation(OR:3.377,95%CI:1.839-6.202)]as the independent risk factors of MDRB infections.Conclusions:Suffering from cerebrovascular disease, the use of broad-spectrum antibiotics in nearly three months and part of the invasive operation,may be the independent risk factors of MDRB infections, suggesting that the clinical doctors should be pay more attention to the risk factors,the focus groups and associated aspects of prevention and treatment to reduce the presence of multidrug resistant bacteria infections.