鲍氏不动杆菌医院感染危险因素的荟萃分析  

Meta analysis of risk factors for Acinetobacter baumannii infections

作　　者：周泓羽[1] 袁喆[2,3] 杜渝平[1] 张为华[1] 易光兆[1] 苏晓琴[1] 

机构地区：[1]重庆医科大学附属第一医院医院感染管理科,重庆400016 [2]重庆医科大学附属第一医院医院感染科,重庆400016 [3]重庆市传染病寄生虫病重点实验室,重庆400016

出　　处：《中华医院感染学杂志》2013年第2期295-297,共3页Chinese Journal of Nosocomiology

基　　金：重庆市自然科学基金(2009BB5061);人事部科研基金(09958013)

摘　　要：目的通过对国内有关鲍氏不动杆菌医院感染危险因素的病例对照研究结果进行荟萃分析,综合评价临床研究所关注的8个危险因素,为鲍氏不动杆菌医院感染的预防策略提供科学依据。方法从中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP-维普)等文献库中,检索2001-2011年国内已发表的相关文献,选择符合标准的临床研究资料进行荟萃分析。结果共有7项病例对照研究入选,通过分析,使用≥3种抗菌药物(OR=8.53,95%CI=5.06～14.37)、使用抗菌药物的疗程(OR=13.98,95%CI=6.92～28.23)、抗菌药物联用(OR=3.79,95%CI=2.07～6.94)、机械通气(OR=5.13,95%CI=2.13～12.34)、深静脉置管(OR=4.39,95%CI=2.57～7.49)差异有统计学意义,而低蛋白血症(OR=1.69,95%CI=0.48～5.89)、使用免疫抑制剂(OR=3.28,95%CI=0.77～13.91)、使用导尿管(OR=2.65,95%CI=0.59～12.00)差异无统计学意义。结论合理使用抗菌药物、减少机械通气及深静脉置管是预防鲍氏不动杆菌医院感染的重要措施。OBJECTIVE To evaluate the clinical concern about eight risk factors through the meta-analysis of the case-control study on the risk factors for Acinetobacter baumannii infections in China so as to provide scientific basis for prevention of A. baumanni infections. METHODS We searched literatures about the risk factors of nosocomial A. baumannii infections in CNKI database, and VIP database, which were published from 2001 to 2011,the meta-analysis of the qualified clinical data was performed. RESULTS Totally 7 control cases were enrolled, the meta analysis showed that the differences in the use of more than three antibiotics （OR= 8.53, 95 % CI=5.06-14.37）, the treatment course of antibiotics （OR=13.98,95%CI=6.92-28.23）, combination use of antibiotics （OR=3.79, 95%CI=2.07-6.94）, mechanical ventilation （OR=5.13,95% CI=2.13-12.34） and using deep venous catheterization （OR = 4. 39,95% CI = 2.57 - 7.49） were statistically significant, while the differences in the hypoproteinemia （OR = 1.69,95 % CI = 0.48 - 5.89）, use of immunosuppressive agents （OR = 3.28, 95%CI=0. 77-13. 91） and use of urinary catheter （OR= 2. 65, 95%CI=0. 59-12. 00） were not statistically significant. CONCLUSION It is important for the prevention of A. baumannii infections to reasonably use antibiotics and the reduce mechanical ventilation.

关 键 词：鲍氏不动杆菌 医院感染 危险因素 荟萃分析 

分 类 号：R181.32[医药卫生—流行病学]