Logistic regression analysis for risk factors of common multidrug-resistant organism infections in a general hospital_West China Medical Journal

Authors：

CHEN Guojian ¹ , YANG Jie ¹ , DENG Ai ¹ , HOU Shaofei ¹ , QIU Yongjie ¹ ,  XU Shilan ²

1. Department of Infection Control, Chengdu Shangjin Nanfu Hospital, Chengdu, Sichuan 611730, P. R. China;
2. Department of Infection Control, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

XU Shilan, Email: shilanxu@hotmail.com

Keywords：

General hospital; Multidrug-resistant organism; Risk factor; Logistic regression analysis

DOI：

10.7507/1002-0179.201912264

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Objective To analyze the risk factors of multidrug-resistant organism (MDRO) nosocomial infection, and to provide the scientific basis for the prevention and control of MDRO nosocomial infection.Methods Patients with MDRO in Chengdu Shangjin Nanfu Hospital from 2014 to 2015 were retrospectively collected. The patients were divided into the MDRO nosocomial infection group and the MDRO non-nosocomial infection group. The MDRO infection/colonization, bacterial strain type, specimens type and distribution characteristics of clinical departments were analyzed. Single factor and multiple factor logistic regression analysis were used to analyze the risk factors of MDRO nosocomial infection.Results A total of 357 patients of MDRO infection/colonization were monitored, of which 147 times (144 patients) were with nosocomial infections and 213 times (213 patients) were without nosocomial infections. MDRO nosocomial infection incidence rate/cases incidence rate were 0.18%. A total of 371 MDRO bacterial strains were detected, of which 147 (39.62%) were with nosocomial infection and 224 (60.38%) were without nosocomial infections. The MDRO non-nosocomial infections included 175 strains (47.17%) in community infection and 49 strains (13.12%) in colonization. Carbapenem-resistant Acinetobacter baumannii (52.83%) was the main MDRO strains. Sputum (57.14%) and secretion (35.04%) were main specimens. The top three departments of MDRO nosocomial infection strains were orthopedics (32.65%), ICU (27.89%), neurosurgery (13.61%). ICU [odds ratio (OR)=3.596, 95% confidence interval (CI) (1.124, 11.501), P=0.031], surgical history [OR=2.858, 95%CI (1.061, 7.701), P=0.038], indwelling urinary catheter [OR=3.250, 95%CI (1.025, 10.306), P=0.045], and using three or more antibiotics [OR=4.228, 95%CI (1.488, 12.011), P=0.007] were the independent risk factors of MDRO nosocomial infection.Conclusion Effective infection prevention and control measures should be adopted for the risk factors of MDRO nosocomial infection to reduce the incidence rate of MDRO nosocomial infection.

Citation： CHEN Guojian, YANG Jie, DENG Ai, HOU Shaofei, QIU Yongjie, XU Shilan. Logistic regression analysis for risk factors of common multidrug-resistant organism infections in a general hospital. West China Medical Journal, 2020, 35(3): 290-295. doi: 10.7507/1002-0179.201912264 Copy

1.	李春輝. MDR、XDR、PDR 多重耐藥菌暫行標準定義—國際專家建議. 中國感染控制雜志, 2014, 13(1): 62-64.
2.	Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect, 2012, 18(3): 268-281.
3.	Perez F, Hujer AM, Hujer KM, et al. Global challenge of multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother, 2007, 51(10): 3471-3484.
4.	周芳, 董亞琳. ICU 多重耐藥菌醫院感染的危險因素分析. 中國藥房, 2017, 28(14): 1916-1920.
5.	謝朝云, 熊蕓, 孫靜, 等. 新生兒重癥監護病房多重耐藥菌感染危險因素 logistic 回歸分析. 臨床兒科雜志, 2016, 34(9): 641-644.
6.	中華人民共和國衛生部. 醫院感染診斷標準 (試行). 中華醫學雜志, 2001, 81(5): 314-320.
7.	許宏濤, 張秀珍. 2004 年美國臨床實驗室標準化委員會藥敏試驗判斷標準. 中國臨床藥理學雜志, 2005, 21(4): 318-320.
8.	中華人民共和國衛生部. 多重耐藥菌醫院感染預防與控制技術指南 (試行). 藥物不良反應雜志, 2011, 13(2): 108-109.
9.	付強, 劉運喜. 醫院感染監測基本數據集及質量控制指標集實施指南 (2016 版). 北京: 人民衛生出版社, 2016: 145-151.
10.	黃勛, 鄧子德, 倪語星, 等. 多重耐藥菌醫院感染預防與控制中國專家共識. 中國感染控制雜志, 2015, 14(1): 1-9.
11.	Quan KA, Cousins SM, Porter DD, et al. Automated tracking and ordering of precautions for multidrug-resistant organisms. AmJ Infect Control, 2015, 43(6): 577-580.
12.	王文娟, 許渝. 2012 年某醫院多重耐藥菌醫院感染目標性監測與分析. 中國消毒學雜志, 2014, 31(3): 271-273.
13.	劉俊杰. 某醫院 2011 年多重耐藥菌分布及耐藥性分析. 中國消毒學雜志, 2014, 31(4): 363-365, 369.
14.	李娜, 黃艷芳, 唐喻瑩, 等. 多重耐藥鮑曼不動桿菌醫院感染危險因素薈萃分析. 中國感染控制雜志, 2017, 16(2): 115-120.
15.	陳佰義, 何禮賢, 胡必杰, 等. 中國鮑曼不動桿菌感染診治與防控專家共識. 中華醫學雜志, 2012, 92(2): 76-85.
16.	Fu Q, Ye H, Liu S. Risk factors for extensive drug-resistance and mortality in geriatric inpatients with bacteremia caused by Acinetobacter baumannii. Am J Infect Control, 2015, 43(8): 857-860.
17.	蔣超群. 鮑氏不動桿菌在臨床科室的分布與耐藥性分析. 中華醫院感染學雜志, 2010, 20(15): 2310.
18.	Lemos EV, de la Hoz FP, Einarson TR, et al. Carbapenem resistance and mortality in patients with Acinetobacter baumannii infection: systematic review and meta-analysis. Clin Microbiol Infect, 2014, 20(5): 416-423.
19.	Behnia M, Logan SC, Fallen L, et al. Nosocomial and ventilator-associated pneumonia in a community hospital intensive care unit: a retrospective review and analysis. BMC Res Notes, 2014, 7: 232.
20.	謝朝云, 閆飛, 熊永發, 等. 骨科開放傷口多重耐藥菌感染危險因素的 Logistic 回歸分析. 中國矯形外科雜志, 2017, 25(2): 108-113.
21.	李凌竹, 冷應蓉, 查筑紅, 等. 某醫院重癥監護病房多重耐藥菌目標監測結果分析. 中國消毒學雜志, 2016, 33(5): 441-442, 445.
22.	劉卉. 神經外科患者多重耐藥菌感染的危險因素分析及對策. 抗感染藥學, 2017, 14(4): 796-798.
23.	Ko?pa M, Wa?aszek M, Gniadek A, et al. Incidence, microbiological profile and risk factors of healthcare-associated infections in intensive care units: a 10 year observation in a provincial hospital in Southern Poland. Int J Environ Res Public Health, 2018, 15(1): pii: E112.
24.	王黎一, 史利克, 王悅. ICU 是多重耐藥鮑曼不動桿菌下呼吸道醫院感染的高危場所. 中國感染控制雜志, 2019, 18(8): 725-731.
25.	Baran G, Erbay A, Bodur H, et al. Risk factors for nosocomial imipenem-resistant Acinetobacter baumannii infections. IntJ Infect Dis, 2008, 12(1): 16-21.
26.	Schwartz KL, Morris SK. Travel and the spread of drug-resistant bacteria. Curr Infect Dis Rep, 2018, 20(9): 29.

1. 李春輝. MDR、XDR、PDR 多重耐藥菌暫行標準定義—國際專家建議. 中國感染控制雜志, 2014, 13(1): 62-64.
2. Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect, 2012, 18(3): 268-281.
3. Perez F, Hujer AM, Hujer KM, et al. Global challenge of multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother, 2007, 51(10): 3471-3484.
4. 周芳, 董亞琳. ICU 多重耐藥菌醫院感染的危險因素分析. 中國藥房, 2017, 28(14): 1916-1920.
5. 謝朝云, 熊蕓, 孫靜, 等. 新生兒重癥監護病房多重耐藥菌感染危險因素 logistic 回歸分析. 臨床兒科雜志, 2016, 34(9): 641-644.
6. 中華人民共和國衛生部. 醫院感染診斷標準 (試行). 中華醫學雜志, 2001, 81(5): 314-320.
7. 許宏濤, 張秀珍. 2004 年美國臨床實驗室標準化委員會藥敏試驗判斷標準. 中國臨床藥理學雜志, 2005, 21(4): 318-320.
8. 中華人民共和國衛生部. 多重耐藥菌醫院感染預防與控制技術指南 (試行). 藥物不良反應雜志, 2011, 13(2): 108-109.
9. 付強, 劉運喜. 醫院感染監測基本數據集及質量控制指標集實施指南 (2016 版). 北京: 人民衛生出版社, 2016: 145-151.
10. 黃勛, 鄧子德, 倪語星, 等. 多重耐藥菌醫院感染預防與控制中國專家共識. 中國感染控制雜志, 2015, 14(1): 1-9.
11. Quan KA, Cousins SM, Porter DD, et al. Automated tracking and ordering of precautions for multidrug-resistant organisms. AmJ Infect Control, 2015, 43(6): 577-580.
12. 王文娟, 許渝. 2012 年某醫院多重耐藥菌醫院感染目標性監測與分析. 中國消毒學雜志, 2014, 31(3): 271-273.
13. 劉俊杰. 某醫院 2011 年多重耐藥菌分布及耐藥性分析. 中國消毒學雜志, 2014, 31(4): 363-365, 369.
14. 李娜, 黃艷芳, 唐喻瑩, 等. 多重耐藥鮑曼不動桿菌醫院感染危險因素薈萃分析. 中國感染控制雜志, 2017, 16(2): 115-120.
15. 陳佰義, 何禮賢, 胡必杰, 等. 中國鮑曼不動桿菌感染診治與防控專家共識. 中華醫學雜志, 2012, 92(2): 76-85.
16. Fu Q, Ye H, Liu S. Risk factors for extensive drug-resistance and mortality in geriatric inpatients with bacteremia caused by Acinetobacter baumannii. Am J Infect Control, 2015, 43(8): 857-860.
17. 蔣超群. 鮑氏不動桿菌在臨床科室的分布與耐藥性分析. 中華醫院感染學雜志, 2010, 20(15): 2310.
18. Lemos EV, de la Hoz FP, Einarson TR, et al. Carbapenem resistance and mortality in patients with Acinetobacter baumannii infection: systematic review and meta-analysis. Clin Microbiol Infect, 2014, 20(5): 416-423.
19. Behnia M, Logan SC, Fallen L, et al. Nosocomial and ventilator-associated pneumonia in a community hospital intensive care unit: a retrospective review and analysis. BMC Res Notes, 2014, 7: 232.
20. 謝朝云, 閆飛, 熊永發, 等. 骨科開放傷口多重耐藥菌感染危險因素的 Logistic 回歸分析. 中國矯形外科雜志, 2017, 25(2): 108-113.
21. 李凌竹, 冷應蓉, 查筑紅, 等. 某醫院重癥監護病房多重耐藥菌目標監測結果分析. 中國消毒學雜志, 2016, 33(5): 441-442, 445.
22. 劉卉. 神經外科患者多重耐藥菌感染的危險因素分析及對策. 抗感染藥學, 2017, 14(4): 796-798.
23. Ko?pa M, Wa?aszek M, Gniadek A, et al. Incidence, microbiological profile and risk factors of healthcare-associated infections in intensive care units: a 10 year observation in a provincial hospital in Southern Poland. Int J Environ Res Public Health, 2018, 15(1): pii: E112.
24. 王黎一, 史利克, 王悅. ICU 是多重耐藥鮑曼不動桿菌下呼吸道醫院感染的高危場所. 中國感染控制雜志, 2019, 18(8): 725-731.
25. Baran G, Erbay A, Bodur H, et al. Risk factors for nosocomial imipenem-resistant Acinetobacter baumannii infections. IntJ Infect Dis, 2008, 12(1): 16-21.
26. Schwartz KL, Morris SK. Travel and the spread of drug-resistant bacteria. Curr Infect Dis Rep, 2018, 20(9): 29.

West China Medical Journal

Logistic regression analysis for risk factors of common multidrug-resistant organism infections in a general hospital

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