目的:观察老年维持性血液透析(MHD)患者多重耐药菌(MDROS)感染病原菌分布情况,并分析老年患者发生MDROS感染的影响因素。方法:收集2015年5月至2022年5月接受MHD治疗的2 760例老年患者的临床资料,根据患者治疗期间MDROS感染发生情况分为感染组与未感染组。收集感染组患者病原菌检查结果,分析其分布情况;多元非条件Logistic回归分析老年MHD患者发生MDROS感染的影响因素。结果:2 760例老年MHD患者中,167例感染MDROS,占6.05%;感染患者共分离出332株病原菌,病原菌主要以金黄色葡萄球菌、鲍氏不动杆菌、铜绿假单胞菌为主,分别占37.05%、20.78%、15.66%。多元非条件Logistic回归分析显示,使用3种及以上抗生素、建立人工气道、中心静脉置管、入侵性操作、机械通气时间 ≥ 7 d、留置尿管可能是导致老年MHD患者发生MDROS感染的影响因素(OR>1,P<0.05)。结论:使用3种及以上抗生素、建立人工气道、中心静脉置管、入侵性操作、机械通气时间 ≥ 7 d、留置尿管可能是导致老年MHD患者发生MDROS感染的影响因素,临床治疗时需积极予以预防措施,以期降低MDROS感染发生率。

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