关键词:

多重耐药菌, 结核病, 预测

Abstract:

Objective To establish a risk model for tuberculosis patients with MDRO infection so as to predict the risk probability of nosocomial infection caused by MDRO in tuberculosis patients. Methods A retrospec⁃ tive analysis was performed on 125 tuberculosis patients hospitalized for more than 48 hours in ICU from January 2020 to March 2021. Patients were divided into MDRO group（n = 65）and non⁃MDRO group（n = 60）Through single factor analysis combined with ICU characteristics，factors that may contribute to the risk of MDRO infection were analyzed. Logistic regression analysis was used to construct the risk model of MDRO infection ，then the predictive diagnostic value of different indexes was compared by receiver operating characteristic. Results Single⁃ factor analysis showed that eight factors such as invasive mechanical ventilation，indwelling urinary tube，indwelling nasal gastrointestinal tube showed statistical significance（P < 0.05）. Logistic regression analysis showed that the misjudgment rate of the risk model was 21.6% for the three variables including placement of nasal gastrointestinal tube，bronchoscopic alveolar lavage and length of ICU stay，which indicated good prediction effect of the risk mode. By comparing the effect of the number of days of indwelling catheters for different types of invasive proce⁃ dures on whether patients developed multidrug⁃resistant bacterial colonization/infection，it was concluded that the operations except placement of thoracic and abdominal drainage tubes were significantly correlated with the occur⁃ rence of multidrug⁃resistant bacteria in tuberculosis patients（P < 0.01）. For the area under ROC curve of MDRO colonization/infection risk prediction of tuberculosis patients based on the placement of nasal gastrointestinal tube， bronchoscopic alveolar lavage，ICU stay and the combined factor. The combined factor is most effective in determin⁃ ing whether a tuberculosis patient has colonization/infection MDRO. Conclusion Indwelling nasal gastrointestinal catheter，bronchoscopic alveolar lavage，length of ICU stay and the combined factor are significant for risk predic⁃tion of MDRO colonization/infection in tuberculosis patients. The prediction probability of combined factors is better than that of single factor.

Key words:

multidrug?resistant bacterial, tuberculosis, prediction