肿瘤重症患者耐碳青霉烯类鲍氏不动杆菌肺炎危险因素分析  

Risk factors for carbapenems-resistant Acinetobacter baumannii pneumonia in severe tumor patients

作　　者：汪道峰[1] 王智[1] 娄宁[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学肿瘤防治中心ICU,广东广州510060

出　　处：《中华医院感染学杂志》2012年第23期5236-5238,共3页Chinese Journal of Nosocomiology

基　　金：广东省科技计划项目(2010B030700051)

摘　　要：目的分析肿瘤专科医院耐碳青霉烯类鲍氏不动杆菌(CRAB)肺炎高危因素以及预后特点,指导临床治疗。方法采用回顾性调查方法,对肿瘤专科医院269例重症患者进行统计分析。结果肿瘤专科医院CRAB肺炎发生率为12.6%,APACHEⅡ评分≥16分、分离出细菌前15d使用亚胺培南、美罗培南、免疫抑制是CRAB肺炎发生的独立危险因素,OR值分别为37.625、3.646及3.084;CRAB肺炎死亡率为52.9%。结论有效治疗原发病,合理使用碳青霉烯类抗菌药物,纠正骨髓抑制可有效减少肿瘤患者CRAB肺炎发生率。OBJECTIVE To investigate the risk factors of hospital-acquired pneumonia（HAP） caused by carbapen- em-resistant Acinetobacter baurnannii （CRAB） in tumor hospital so as to guide the clinical treatment. METHODS By means of retrospective investigation, a total of 269 severe tumor patients were statistically analyzed. RESULTS The incidence rate of CRAB pneumonia was 12. 6%. Multivariate logistic regression analysis showed that the APACHE 11 score more than 16 points ,the use of imipenem/meropenem 15 days before the isolation of CRAB, and the use of bone marrow suppression were the independent risk factors for CRAB, the value of which were 37. 625, 3. 646 and 3. 084, respectively; the mortality due to CRAB pneumonia was 52.9 %. CONCLUSION The effective treatment of the primary diseases, reasonable use of carbapenems and proper use of bone marrow suppression can effectively reduce the incidence of CRAB pneumonia.

关 键 词：肿瘤 医院获得性肺炎 耐碳青霉烯类 鲍氏不动杆菌 危险因素 

分 类 号：R181.32[医药卫生—流行病学]