慢性化脓性中耳炎多重耐药菌感染相关因素logistic回归分析
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摘要
目的分析慢性化脓性中耳炎患者多重耐药菌感染的相关因素。方法收集323例慢性化脓性中耳炎患者临床资料,对细菌培养是否检出多重耐药菌进行相关因素分析。结果多因素分析显示抗菌药物使用频次(>3次/年)、发病持续时间(>7d)、反复上呼吸道感染(>3次/年)、慢性鼻窦炎、发病频次(≥3次/年)等是独立危险因素(P<0.05),显微外科治疗是独立保护性因素(P<0.05)。结论临床应针对主要相关因素为主的综合有效防控措施,减少慢性中耳炎患者多重耐药菌感染产生。
Objective To report factors relevant to multidrug-resistant bacterial infection in patients with chronic suppurative otitis media. Methods Clinical data from 323 patients with chronic suppurative otitis media were collected,and factors related to positive culture of multidrug-resistant bacteria were analyzed. Results Multivariate analysis showed that the frequency of use of antimicrobial drugs(> 3 times/year), disease duration(> 7D), recurrent upper respiratory tract infection(>3/year), chronic sinusitis and frequency of exacerbation(≥3/year) were independent risk factors(P < 0.05). Surgical treatment was the only independent protective factor(P < 0.05). Conclusion Prevention and management measures should be focused on the risk factors revealed in this study to reduce the incidence of multidrug-resistant bacteria infection in patients with chronic otitis media.
Objective To report factors relevant to multidrug-resistant bacterial infection in patients with chronic suppurative otitis media. Methods Clinical data from 323 patients with chronic suppurative otitis media were collected,and factors related to positive culture of multidrug-resistant bacteria were analyzed. Results Multivariate analysis showed that the frequency of use of antimicrobial drugs(> 3 times/year), disease duration(> 7D), recurrent upper respiratory tract infection(>3/year), chronic sinusitis and frequency of exacerbation(≥3/year) were independent risk factors(P < 0.05). Surgical treatment was the only independent protective factor(P < 0.05). Conclusion Prevention and management measures should be focused on the risk factors revealed in this study to reduce the incidence of multidrug-resistant bacteria infection in patients with chronic otitis media.
引文
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9柯嘉,姜立伟,潘滔,等.儿童及青少年中耳炎听力损失相关因素分析[J].中华耳科学杂志,2016,14(1):62-66.Ke J,Jiang LW,Pan T,et al.Analysis of factors related to hearing loss in children and adolescents with otitis media[J].Chinese Journal of Otology,2016,14(1):62-66.
10盖建青,孙宝霞,艾建伟,等.中药耳净散治疗慢性化脓性中耳炎活动期的应用研究[J].中华耳科学杂志,2017,15(2):191-194.Gai JQ,Sun BX,Ai JW,et al.Er jing san in treating active chronic suppurative otitis media[J].Chinese Journal of Otology,2017,15(2):191-194.
2马芙蓉,柯嘉.慢性化脓性中耳炎的分型与诊断治疗进展[J].临床耳鼻咽喉头颈外科杂志,2017,31(16):1225-1227.Ma FR,KeJ.Classification diagnosis and surgical management of chronic suppurative otitis media[J].Clin Otorhinolaryngol Head Neck Surg(China),2017,31(16):1225-1227.
3孙建军,刘阳.中耳炎临床分类和手术分型指南(2012)解读[J].中华耳鼻咽喉头颈外科杂志,2013,48(1):6-10.Sun JJ,Liu Y.Interpretation of clinical classification and surgical typing of otitis media(2012)[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2013,48(1):6-10.
4于巧莲,田广永.慢性中耳炎手术中面神经水平段的保护[J],中华耳科学杂志,2014,11(3):423-425.Yu QL,Tian GY.Protection of horizontal segment of facial nerve in surgeries for chronic otitis media[J],Chinese Journal of Otology,2014,11(3):423-425.
6兰贤斌,彭韶平.赣南地区慢性化脓性中耳炎主要病原菌种类及药敏分析[J].赣南医学院学报,2017,37(2):220-223.Lan XB,Peng SP.Analysis of the main pathogenic bacteria species and drug sensitivity in patients with chronic suppurative otitis media in gannan area[J].Journal of Gannan Medical University,2017,37(2):220-223.
7陈晧.急性化脓性中耳炎合并慢性鼻窦炎的临床观察[J].医学理论与实践,2014,27(22):3027-3028.Chen H.Clinical observation of acute suppurative otitis media complicated with chronic sinusitis[J].Journal of Medical Theory and Practice,2014,27(22):3027-3028.
8韩琳,王梦航,郑宏伟,等.慢性化脓性中耳炎鼓膜紧张部大穿孔手术方法的选择[J].中华耳科学杂志,2017,14(2):247-250.Han L,Wang MH,Zheng HW,et al.The choice of surgical method for tympanic membrane perforation in chronic suppurative otitis media[J].,Chinese Journal of Otology,2017,14(2):247-250.
9柯嘉,姜立伟,潘滔,等.儿童及青少年中耳炎听力损失相关因素分析[J].中华耳科学杂志,2016,14(1):62-66.Ke J,Jiang LW,Pan T,et al.Analysis of factors related to hearing loss in children and adolescents with otitis media[J].Chinese Journal of Otology,2016,14(1):62-66.
10盖建青,孙宝霞,艾建伟,等.中药耳净散治疗慢性化脓性中耳炎活动期的应用研究[J].中华耳科学杂志,2017,15(2):191-194.Gai JQ,Sun BX,Ai JW,et al.Er jing san in treating active chronic suppurative otitis media[J].Chinese Journal of Otology,2017,15(2):191-194.