住院患者导尿管相关尿路感染危险因素的Meta分析
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李显蓉

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R181.3+2

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四川省科技厅项目(2016SZ0062)


Risk factors for catheterassociated urinary tract infection in hospitalized patients: a Meta analysis
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    摘要:

    目的探讨住院患者导尿管相关尿路感染(CAUTI)的危险因素,为其预防提供参考依据。方法计算机检索中国知网(CNKI)、万方、维普、中国生物医学文献数据库(CBM)以及PubMed,查找国内外2007—2017年有关住院患者CAUTI危险因素的病例对照研究。在进行文献筛选、资料提取和质量评价后,采用Revman 5.3软件进行定量综合分析,计算各个危险因素合并OR值及其95%可信区间(CI)。结果共纳入文献10篇,累计2 652例患者。从文献中提取出对CAUTI有预测价值的7个危险因素,Meta分析结果显示各因素的合并OR值及其95%CI分别为:导尿管留置时间(OR=1.57,95%CI:1.33~1.86)、年龄≥60岁(OR=2.24,95%CI:1.09~4.59)、性别(OR=1.21,95%CI:0.54~2.72)、糖尿病(OR=3.49,95%CI:2.61~4.66)、抗菌药物使用(OR=2.58,95%CI:0.70~9.55)、意识障碍(OR=4.51,95%CI:3.33~6.09)、置管次数≥2次(OR=2.60,95%CI:1.62~4.18)。除性别、抗菌药物使用两个危险因素未显示有统计学意义之外(P>0.05),其他因素的合并结果均具有统计学意义(均P<0.05)。结论导尿管留置时间≥5 d、患者年龄≥60岁、合并糖尿病、意识障碍以及置管次数≥2次是CAUTI的主要危险因素;性别和抗菌药物使用对CAUTI的预测价值有待进一步探讨。护理人员应对以上因素予以重点关注,采取针对性的预防措施以减少CAUTI的发生。

    Abstract:

    ObjectiveTo explore risk factors for catheterassociated urinary tract infection (CAUTI) in hospitalized patients, and provide reference for prevention of CAUTI.MethodsCase control studies about the risk factors for CAUTI in hospitalized patients were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, China Biology Medicine (CBM), and PubMed from 2007 to 2017. After literature screen, data extraction, and quality evaluation were performed, Revman 5.3 software was used to carry out comprehensive quantitative analysis, OR value and 95% confidence interval (CI) for each risk factor was calculated.ResultsA total of 10 literatures were included, with a total of 2 652 patients. Seven risk factors that with predictive value for CAUTI were extracted from literatures, Meta analysis results showed that the combined OR value of each factor and its 95%CI were as follows: urinary catheter indwelling time (OR, 1.57 [95%CI, 1.33-1.86]), age≥60 years (OR, 2.24 [95%CI, 1.09-4.59]), gender (OR, 1.21 [95%CI, 0.54-2.72]), diabetes mellitus (OR, 3.49 [95%CI, 2.61-4.66]), antimicrobial use (OR, 2.58 [95%CI, 0.70-9.55]), disturbance of consciousness (OR, 4.51 [95%CI, 3.33-6.09]), and No. of intubation≥2 times (OR, 2.60 [95%CI,1.62-4.18]). Two risk factors (gender and antimicrobial use) were not statistically significant(P>0.05), combined results of other factors were statistically significant (all P<0.05).ConclusionUrinary indwelling time≥5 days, patients’ age≥60 years, combined with diabetes mellitus, disturbance of consciousness, and No. of intubation≥2 times are  main risk factors for CAUTI; predictive value of gender and antimicrobial use in CAUTI needs to be further evaluated. Nursing staff should pay more attention to the above factors and take specific preventive measures to reduce the incidence of CAUTI.

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引用本文

李飞,邓波,朱世琴,等.住院患者导尿管相关尿路感染危险因素的Meta分析[J]. 中国感染控制杂志,2018,17(9):770-776. DOI:10.3969/j. issn.1671-9638.2018.09.004.
LI Fei, DENG Bo, ZHU Shiqin, et al. Risk factors for catheterassociated urinary tract infection in hospitalized patients: a Meta analysis[J]. Chin J Infect Control, 2018,17(9):770-776. DOI:10.3969/j. issn.1671-9638.2018.09.004.

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  • 收稿日期:2017-11-20
  • 最后修改日期:2018-01-12
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  • 在线发布日期: 2018-09-28
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