Risk Factors For Lower Respiratory Tract Caused By Multidrug Resistant Bacteria Infections

Background and Objective:With the wide use of antimicrobial drugs and the increase of drug-resistant strains, lower respiratory tract infections caused by multidrug resistant bacteria(MDRB) increased, and the difficulty of clinical treatment increased.The study analysis the risk factors for lower respiratory tract caused by multidrug resistant bacteria infections in order to provide evidence for prevention and controlling measure of MDRB infections.Methods:208 patients with lower respiratory tract infections and positive results (>2)in bacteria culture in sputum for the same strains were divided into MDRB infections group and Non-MDRB infections group according to diagnostic criteria of MDRB infections in the period of October 1 2010 to March 31 2011.18 related factors such as general data, basic diseases, Pathogens and antimicrobial susceptibility test results of sputum cultures, invasive treatment measures, use of antimicrobial drugs and hormones and other factors were investigated on these patients.Several statistically significant risk factors were screened out with single factor analysis, thereafter independent risk factors of MDRB infections were determined with multivariate logistic regression analysis.Results:1. There were 112 patients in MDRB infections group,their average age were 64.87±16.48 years,79 patients (70.5%)were male of these; There were 96 patients in Non-MDRB infections group,their average age were 64.54±15.22 years,69 patients (71.4%)were male of these.2.The single factor analysis results of MDRB infections'related factors showed that smoking history, the days in hospital before positive results in bacteria culture in sputum, COPD, cerebrovascular disease and recent use of antimicrobial drugs, indwellining gstric tube, indwelling urine tube, deep vein intubation, mechanical ventilation, use of antimicrobial drugs and hormones in hospital were related to MDRB infections(P<0.05).3.In the multivariable logistic analysis, smoking history(OR:1.821,95% CI:1.193-2.779),the days in hospital before positive results in bacteria culture in sputum(OR:1.131,95% CI:1.009-1.268), indwellin gstric tube(OR:6.537,95% CI:2.913-14.667),mechanical ventilation(OR:2.818,95% CI:1.079-7.358) and use of antimicrobial drugs (OR:1.056,95% CI: 0.549-2.030) were significantly associated with MDRB infections.Conclusions:Various factors included the patient condition, invasive treatment measures and the hospital environment contributed to lower respiratory tract infections caused by multidrug resistant bacteria infections. Smoking history, the days in hospital before positive results in bacteria culture in sputum, indwellining gstric tube,mechanical ventilation and use of antimicrobial drugs were significantly related to MDRB infections,they may be the independent risk factors of MDRB infections.