院內感染抗藥性葡萄球菌菌血症危險因素之探討

Risk Factors of Nosocomial Oxacillin-Resistant Staphylococci Bacteremia

陳瑛瑛(Yin-Yin Chen) ； 王復德(Fu-Der Wang) ； 周碧瑟(Pesus Chou)

《榮總護理》 22卷4期 (2005/12) Pp. 339-347

https://doi.org/10.6142/VGHN.22.4.339

摘要

This retrospective observational study examined the risk factors of nosocomial oxacillin-resistant Staphylococci bacteremia in adult ICUs. During the research period, the crude infection rate was 12.5 per 1000 patients. Of the Staphylococci bacteremia, Staphylococcus aureus was 87%; of them, oxacillin-resistant Staphylococcus aureus (ORSA) was 92.3% and coagulase-negative Staphylococci was 13%, with oxacillin-resistant 96.3%. After controlling other risk factors for oxacillin-resistant Staphylococci on Cox regression analysis, the Swan-Ganz catheter (odds ratio 2.05, 95% confidence interval 1.36-3.08, p＜.001) was an independent risk factor. According to the Kaplan-Meier estimator analysis, the median survival time of hospital stay before the onset of oxacillin-resistant Staphylococci bacteremia was 23 days in medical ICU, 25 days in surgical ICU, and on 13 days in mix medical and surgical ICU, respectively. There was statistically significant difference by log rank test (p＜.05). Conclusion: The use of invasive equipment was an important risk factor in nosocomial staphylococci bacteremia in ICU.

關鍵字

院內感染 ； 葡萄球菌 ； 菌血症

並列摘要

This retrospective observational study examined the risk factors of nosocomial oxacillin-resistant Staphylococci bacteremia in adult ICUs. During the research period, the crude infection rate was 12.5 per 1000 patients. Of the Staphylococci bacteremia, Staphylococcus aureus was 87%; of them, oxacillin-resistant Staphylococcus aureus (ORSA) was 92.3% and coagulase-negative Staphylococci was 13%, with oxacillin-resistant 96.3%. After controlling other risk factors for oxacillin-resistant Staphylococci on Cox regression analysis, the Swan-Ganz catheter (odds ratio 2.05, 95% confidence interval 1.36-3.08, p＜.001) was an independent risk factor. According to the Kaplan-Meier estimator analysis, the median survival time of hospital stay before the onset of oxacillin-resistant Staphylococci bacteremia was 23 days in medical ICU, 25 days in surgical ICU, and on 13 days in mix medical and surgical ICU, respectively. There was statistically significant difference by log rank test (p＜.05). Conclusion: The use of invasive equipment was an important risk factor in nosocomial staphylococci bacteremia in ICU.

並列關鍵字

nosocomial infection ； staphylococci ； bacteremia