在住院患者中与抗卡巴因的肠细菌感染相关的危险因素:一个病例对照研究
Vivian Zambrano-Calderero1, Fabricio Vera-Álava2, Marcio Borges3
1Faculty of Health Sciences, Universidad Laica Eloy Alfaro de Manabí, Manta, Ecuador.
Le infezioni in medicina
|March 6, 2026
概括
感染发病的时间是对抗卡巴胺抗性肠道细菌 (CRE) 感染的关键风险因素. 其他风险包括皮质类固醇治疗和先前住院治疗,而医院来源提供了保护.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 临床微生物学 临床微生物学
背景情况:
- 耐卡巴胺肠道细菌 (CRE) 构成了严重的全球健康威胁.
- 了解CRE感染的风险因素对于有效的预防和控制策略至关重要.
研究的目的:
- 在厄瓜多尔曼塔的一家二级医院的成年患者中识别和分析与CRE感染相关的风险因素.
主要方法:
- 采用了病例控制研究设计,将患有CRE感染的患者 (病例) 与患有Carbapenem-Susceptible Enterobacterales (CSE) (对照) 的患者进行比较.
- 总共有27个病例和193个对照被纳入分析.
- 在单变量和多变量分析中使用Firth逻辑回归来解释小样本偏差.
主要成果:
- 对CRE感染的最重要的预测因素是医疗保健暴露的累积持续时间 (感染开始的时间) (aOR:1.08;p=0.001).
- 其他确定的风险因素包括慢性皮质类固醇治疗 (aOR: 43.10; p=0.005),先前住院治疗 (aOR: 14.52; p=0.005),尿导管使用 (aOR: 10.39; p=0.003) 和中央静脉导管 (aOR: 13.46; p=0.029).
- 鼻腔来源 (aOR:0.05;p=0.039) 和内科治疗 (aOR:0.23;p=0.041) 证明了对CRE感染的保护作用.
结论:
- 在这种特定的医疗保健环境中,医疗保健暴露的持续时间是CRE风险的主要驱动因素.
- 鉴定的风险因素取决于环境,需要进行本地监测和进一步的多中心研究,以了解区域性耐药性模式.
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