重症监护病房血流感染危险因素的Meta分析

doi:10.3969/j.issn.1006-7795.2021.06.004

摘要/Abstract

摘要： 目的探讨重症监护病房(intensive care unit,ICU)患者发生血流感染(blood stream infection,BSI)的危险因素。方法在英文数据库Cochrane Library、PubMed、Embase、Web of Science及中文数据库CBM、中国知网、万方、维普检索关于BSI危险因素的相关文献,检索时间为从各数据库建库至2021年4月,通过双人交叉纳入、排除、提取最终获得文献的效应量,使用Revman 5.0进行数据分析,评估了研究异质性和偏倚风险。结果获得参考文献13 691篇,经过纳入、排除后最终获得符合要求的文献11篇,采用(Newcastle-Ottawa Scale,NOS)量表对纳入研究的方法学质量进行评分,最终结果显示危重症患者发生BSI的危险因素有以下8项:肠外营养(OR=5.07,95%CI:2.89~9.10)、呼吸衰竭(OR=3.03,95%CI:1.90~4.83)、脓毒症(OR=2.13,95%CI:1.50~3.01)、深静脉置管(OR=3.57,95%CI:2.16~5.90)、免疫抑制(OR=3.52,95%CI:1.72~7.20)、机械通气(OR=5.28,95%CI:2.05~13.62)、心脏事件(OR=3.07,95%CI:1.68~5.62)、既往暴露于抗生素(OR=2.46,95%CI:1.14~5.33)。结论初步阐明重症监护病房患者发生BSI的危险因素包括肠外营养、呼吸衰竭、脓毒症、深静脉置管、免疫抑制、机械通气、心脏事件、既往暴露于抗生素。

关键词: 血流感染, 危险因素, 重症监护病房

Abstract: Objective To investigate the risk factors of bloodstream infections (BSI) in intensive care unit (ICU). Methods We screened the studies in English databases (Cochrane Library, PubMed, Embase, Web of Science) and Chinese databases (CBM, CNKI, Wanfang, Weipu) from each starting year to April 2021.Two investigators independently reviewed the articles and extracted the information according to the established inclusion and exclusion criteria, and cross-checked. Data analysis was performed by the software RevMan5, and the heterogeneity among the study and risk of bias were also evaluated. Results Among the initial identified 13 691 articles, 11 studies were brought into study. Our results showed that risk factors of BSI are parenteral nutrition (OR=5.07,95%CI:2.89-9.10), respiratory failure(OR=3.03,95%CI:1.90-4.83), sepsis(OR=2.13,95%CI:1.50-3.01), central venous catheterization(OR=3.57,95%CI:2.16-5.90), immunosuppression(OR=3.52,95%CI:1.72-7.20),mechanical ventilation(OR=5.28,95%CI:2.05-13.62), cardiovascular events(OR=3.07,95%CI:1.68-5.62), and previous antibiotic exposure(OR=2.46,95%CI:1.14-5.33). Conclusion The risk factors of BSI in the ICU included parenteral nutrition, respiratory failure, sepsis, central venous catheterization, immunosuppression, mechanical ventilation, cardiovascular events, and previous antibiotic exposure.

Key words: bloodstream infections, risk factors, intensive care unit

中图分类号:

R195.4

齐志丽, 林瑾, 董磊, 刘景峰, 段美丽. 重症监护病房血流感染危险因素的Meta分析[J]. 首都医科大学学报, 2021, 42(6): 923-930.

Qi Zhili, Lin Jin, Dong Lei, Liu Jingfeng, Duan Meili. Meta-analysis of risk factors for bloodstream infections in intensive care unit[J]. Journal of Capital Medical University, 2021, 42(6): 923-930.

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