老年恶性肿瘤患者院内感染和多重耐药菌感染风险的影响因素分析

doi:10.19871/j.cnki.xfcrbzz.2024.03.011

新发传染病电子杂志 ›› 2024, Vol. 9 ›› Issue (3): 51-55.doi: 10.19871/j.cnki.xfcrbzz.2024.03.011

老年恶性肿瘤患者院内感染和多重耐药菌感染风险的影响因素分析

王頔^1,2, 张梦³, 王蕊^1,2, 谭驰宇^1,2, 胡兴蔚⁴, 王哲^1,2

1.中国医科大学附属盛京医院病理科,辽宁沈阳 110000;
2.中国医科大学胃肠肿瘤精准诊疗教育部重点实验室,辽宁沈阳 110000;
3.中国医科大学附属盛京医院肿瘤内科,辽宁沈阳 110000;
4.中国医科大学附属盛京医院检验科,辽宁沈阳 110000

收稿日期:2024-02-02 出版日期:2024-06-30 发布日期:2024-07-23
通讯作者: 王哲,Email：wangz@sj-hospital.org

Analysis of factors influencing the risk of nosocomial and MDRO infections in elderly patients with malignant tumours

Wang Di^1,2, Zhang Meng³, Wang Rui^1,2, Tan Chiyu^1,2, Hu Xingwei⁴, Wang Zhe^1,2

1. Department of Pathology, Shengjing Hospital, China Medical University, Liaoning Shenyang 110000, China;
2. Key Laboratory of Cancer Intelligent and Accurate Pathology Diagnosis, Liaoning Shenyang 110000, China;
3. Department of Medical Oncology, Shengjing Hospital Affiliated to China Medical University, Liaoning Shenyang 110000, China;
4. Laboratory of Shengjing Hospital Affiliated to China Medical University, Liaoning Shenyang 110000, China

Received:2024-02-02 Online:2024-06-30 Published:2024-07-23

摘要/Abstract

摘要： 目的分析老年恶性肿瘤患者发生院内感染和多重耐药菌（multi-drugresistantbacteria,MDRO）感染的影响因素,为制定有效的预防控制措施提供科学依据。方法选取2016年6月至2023年1月中国医科大学附属盛京医院收治的782例60岁及以上恶性肿瘤患者为研究对象分为无院内感染组（529例）、院内感染组（253例）,其中院内感染包括MDRO感染（156例）和非MDRO感染（97例）,比较两组患者临床资料,将单因素分析中有统计学意义的指标进行多因素Logistic回归分析,分析老年恶性肿瘤患者院内感染和MDRO感染的危险因素。结果老年恶性肿瘤患者发生院内感染和MDRO感染的比例分别为32.35%和61.66%。单因素分析结果表明,两组患者在慢性疾病、身体衰弱情况、侵入性操作、恶性肿瘤、住院时间≥14d、重症监护室入住时间≥1周、长期卧床、低蛋白水平的比较,差异有统计学意义（P<0.05）;Logistic回归结果表明：衰弱情况、侵入性操作、恶性肿瘤、住院时间≥14d、重症监护室入住时间≥1周、长期卧床是老年恶性肿瘤患者发生院内感染及MDRO感染的主要危险因素;慢性疾病、低蛋白水平为院内感染的独立危险因素;使用抗菌药物≥3种、抗菌药物应用时间≥14d是MDRO感染的独立危险因素。结论老年恶性肿瘤患者院内感染和MDRO感染发生率较高,其影响因素多样,须对其进行科学、有效地分析,为减少感染发生率,提高患者的治疗效果和生命质量提供科学依据。

关键词: 恶性肿瘤, 老年患者, 院内感染, 多重耐药菌感染

Abstract: Objective To analyse the influencing factors of nosocomial infections and Multi-drug-resistantbacteria (MDRO) infections in elderly patients with malignant tumours, and to provide a scientific basis for the development of effective preventive and control measures. Method 782 malignant tumour patients aged 60 years and above admitted to Shengjing Hospital of China Medical University between June 2016 and January 2023 were selected and divided into no nosocomial infection group(529 cases) and nosocomial infection group(253 cases), of which nosocomial infection included MDRO infection group(156 cases) and non-MDRO infection group(97 cases), and the patients' medical records were reviewed and collected. Multivariate Logistic regression analysis was applied to analyze the indexes with significant differences in the univariate analysis, to assess the impact of nosocomial infection and MDRO infection on the elderly patients. The risk factors of nosocomial infection and MDRO infection in elderly patients with malignant tumours were studied using multifactorial logistic regression analysis. Result The proportions of nosocomial infections and MDRO infections among nosocomial infections in elderly patients with malignant tumours were 32.35% and 61.66%, respectively. The results of univariate analysis showed that there was a statistically significant difference between the two groups of patients in terms of chronic disease, physical weakness, invasive procedures, malignant tumors, hospital stay ≥ 14 days, intensive care unit stay ≥ 1 week, long-term bed rest, and low protein levels (P<0.05)the results of logistic regression showed that: debilitating conditions, invasive operations, malignant tumours, hospital stay ≥14d, intensive care unit stay ≥1 week, and prolonged bed rest were the main risk factors of nosocomial infections and MDRO infections in elderly patients with malignant tumours; chronic diseases, low protein level and low blood pressure were the main risk factors of nosocomial infections in elderly patients with malignant tumours. risk factors; chronic diseases and low protein level were independent risk factors for nosocomial infections; use of ≥3 antimicrobial drugs and antimicrobial application time ≥14d were independent risk factors for MDRO infections. Conclusion The incidence of nosocomial infections and MDRO infections in elderly patients with malignant tumours is high, and their influencing factors are diverse, which must be analysed scientifically and effectively to provide scientific basis for reducing the incidence of infections and improving the therapeutic efficacy and quality of life of patients.

Key words: Pneumonia, Respiratory syncytial virus, Transforming growth factor-β, Interleukin-23, Severity of the disease, Correlation

中图分类号:

R730

王頔, 张梦, 王蕊, 谭驰宇, 胡兴蔚, 王哲. 老年恶性肿瘤患者院内感染和多重耐药菌感染风险的影响因素分析[J]. 新发传染病电子杂志, 2024, 9(3): 51-55.

Wang Di, Zhang Meng, Wang Rui, Tan Chiyu, Hu Xingwei, Wang Zhe. Analysis of factors influencing the risk of nosocomial and MDRO infections in elderly patients with malignant tumours[J]. Electronic Journal of Emerging Infectious Diseases, 2024, 9(3): 51-55.

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老年恶性肿瘤患者院内感染和多重耐药菌感染风险的影响因素分析

Analysis of factors influencing the risk of nosocomial and MDRO infections in elderly patients with malignant tumours

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