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.	李春辉. MDR、XDR、PDR 多重耐药菌暂行标准定义—国际专家建议. 中国感染控制杂志, 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, 董亚琳. ICU 多重耐药菌医院感染的危险因素分析. 中国药房, 2017, 28(14): 1916-1920.
5.	谢朝云, 熊芸, 孙静, 等. 新生儿重症监护病房多重耐药菌感染危险因素 logistic 回归分析. 临床儿科杂志, 2016, 34(9): 641-644.
6.	中华人民共和国卫生部. 医院感染诊断标准 (试行). 中华医学杂志, 2001, 81(5): 314-320.
7.	许宏涛, 张秀珍. 2004 年美国临床实验室标准化委员会药敏试验判断标准. 中国临床药理学杂志, 2005, 21(4): 318-320.
8.	中华人民共和国卫生部. 多重耐药菌医院感染预防与控制技术指南 (试行). 药物不良反应杂志, 2011, 13(2): 108-109.
9.	付强, 刘运喜. 医院感染监测基本数据集及质量控制指标集实施指南 (2016 版). 北京: 人民卫生出版社, 2016: 145-151.
10.	黄勋, 邓子德, 倪语星, 等. 多重耐药菌医院感染预防与控制中国专家共识. 中国感染控制杂志, 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, 许渝. 2012 年某医院多重耐药菌医院感染目标性监测与分析. 中国消毒学杂志, 2014, 31(3): 271-273.
13.	刘俊杰. 某医院 2011 年多重耐药菌分布及耐药性分析. 中国消毒学杂志, 2014, 31(4): 363-365, 369.
14.	李娜, 黄艳芳, 唐喻莹, 等. 多重耐药鲍曼不动杆菌医院感染危险因素荟萃分析. 中国感染控制杂志, 2017, 16(2): 115-120.
15.	陈佰义, 何礼贤, 胡必杰, 等. 中国鲍曼不动杆菌感染诊治与防控专家共识. 中华医学杂志, 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.	蒋超群. 鲍氏不动杆菌在临床科室的分布与耐药性分析. 中华医院感染学杂志, 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.	谢朝云, 闫飞, 熊永发, 等. 骨科开放伤口多重耐药菌感染危险因素的 Logistic 回归分析. 中国矫形外科杂志, 2017, 25(2): 108-113.
21.	李凌竹, 冷应蓉, 查筑红, 等. 某医院重症监护病房多重耐药菌目标监测结果分析. 中国消毒学杂志, 2016, 33(5): 441-442, 445.
22.	刘卉. 神经外科患者多重耐药菌感染的危险因素分析及对策. 抗感染药学, 2017, 14(4): 796-798.
23.	Kołpa M, Wałaszek 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, 王悦. ICU 是多重耐药鲍曼不动杆菌下呼吸道医院感染的高危场所. 中国感染控制杂志, 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. 李春辉. MDR、XDR、PDR 多重耐药菌暂行标准定义—国际专家建议. 中国感染控制杂志, 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, 董亚琳. ICU 多重耐药菌医院感染的危险因素分析. 中国药房, 2017, 28(14): 1916-1920.
5. 谢朝云, 熊芸, 孙静, 等. 新生儿重症监护病房多重耐药菌感染危险因素 logistic 回归分析. 临床儿科杂志, 2016, 34(9): 641-644.
6. 中华人民共和国卫生部. 医院感染诊断标准 (试行). 中华医学杂志, 2001, 81(5): 314-320.
7. 许宏涛, 张秀珍. 2004 年美国临床实验室标准化委员会药敏试验判断标准. 中国临床药理学杂志, 2005, 21(4): 318-320.
8. 中华人民共和国卫生部. 多重耐药菌医院感染预防与控制技术指南 (试行). 药物不良反应杂志, 2011, 13(2): 108-109.
9. 付强, 刘运喜. 医院感染监测基本数据集及质量控制指标集实施指南 (2016 版). 北京: 人民卫生出版社, 2016: 145-151.
10. 黄勋, 邓子德, 倪语星, 等. 多重耐药菌医院感染预防与控制中国专家共识. 中国感染控制杂志, 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, 许渝. 2012 年某医院多重耐药菌医院感染目标性监测与分析. 中国消毒学杂志, 2014, 31(3): 271-273.
13. 刘俊杰. 某医院 2011 年多重耐药菌分布及耐药性分析. 中国消毒学杂志, 2014, 31(4): 363-365, 369.
14. 李娜, 黄艳芳, 唐喻莹, 等. 多重耐药鲍曼不动杆菌医院感染危险因素荟萃分析. 中国感染控制杂志, 2017, 16(2): 115-120.
15. 陈佰义, 何礼贤, 胡必杰, 等. 中国鲍曼不动杆菌感染诊治与防控专家共识. 中华医学杂志, 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. 蒋超群. 鲍氏不动杆菌在临床科室的分布与耐药性分析. 中华医院感染学杂志, 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. 谢朝云, 闫飞, 熊永发, 等. 骨科开放伤口多重耐药菌感染危险因素的 Logistic 回归分析. 中国矫形外科杂志, 2017, 25(2): 108-113.
21. 李凌竹, 冷应蓉, 查筑红, 等. 某医院重症监护病房多重耐药菌目标监测结果分析. 中国消毒学杂志, 2016, 33(5): 441-442, 445.
22. 刘卉. 神经外科患者多重耐药菌感染的危险因素分析及对策. 抗感染药学, 2017, 14(4): 796-798.
23. Kołpa M, Wałaszek 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, 王悦. ICU 是多重耐药鲍曼不动杆菌下呼吸道医院感染的高危场所. 中国感染控制杂志, 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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