Study On The Risk Factors Of Carbapenem Resistant Bacteria In The Enterogenes

Objective:Risk factors of carbapenem-resistant Enterobacteriaceae(CRE)were analyzed,the cultured strains were tested for drug sensitivity by meropenem,and the drug-resistant strains were identified by mass spectrometry.Clinical data were collected and analyzed to provide a basis for the control of nosocomial CRE infection.Methods:1.Case control study was adopted to conduct active CRE screening for hospitalized patients in the hematology department of the first affiliated hospital of nanchang university from January 2019 to September 2019.14 patients with positive CRE value were set as the group,and 348 patients with negative CRE value were set as the control group.2.collected on admission(48 hours)or carbon penicillium alkene antibiotic exposure of patients after defecate and pharyngeal swab sent to the microorganism laboratory,within 2 hours of vaccination in Colombia and swabs blood stool tablet,and post the e.faecalis paper processing,in the 35 ? + 2 ? temperature box for training after 18 to 24 hours to mass spectrum identification of strains.3.2 groups of age,gender,record coexisting diseases(cardiovascular disease,diabetes,liver disease,chronic kidney disease,lung disease,HIV),blood tests for screening the prothrombin time(PT,HB,leukocyte WBC,PLT,hemoglobin neutrophils,transaminase,albumin propagated,kidney),screening in the first three months of length of hospital stay and number of bone marrow biopsy,blood system tumor(lymphocytic leukemia,myelogenous leukemia,lymphoma,myeloma),number of screening in the year before chemotherapy and admission,within one month before the screening of blood transfusion red protein and plasma transfusion,the use of immune preparations,One,two,three or more antibiotics were used in the first three months of screening,the types of antibiotics were used in the first three months of screening,lumbar puncture intrasheath administration,hematopoietic stemcell transplantation,CRE invasive infection and other clinical data4.Univariate analysis and multivariate logistic regression analysis were used to explore the risk factors related to CRE determination,and the incidence of invasive CRE infection during hospitalization was monitored.Results:1.The neutrophils <0.5×10~9/L,the use of carbapenems antibiotics in the first three months of screening,the use of > chemotherapy for 5 times in the previous year of screening,and the transfer to the department/hospital were independent risk factors for CRE values.2.The CRE rate was 3.87%(14/362),the most common was carbapenem resistant klebsiella pneumoniae(62.50%(10/16),and the incidence of CRE was4.03/1000 days.3.The incidence of invasive CRE infection was 57.14%(8/14)and 6.89%(24/348)in the CRE fixed-value group and the control group,respectively.Conclusion:1.CRE setting can significantly increase the probability of invasive infection,identify the risk factors of CRE setting in hematology department,and use early screening and monitoring to find CRE setting,which is conducive to the prevention and control of CRE.