鲍曼不动杆菌所致呼吸机相关性肺炎危险因素及疾病经济负担  

Risk factors and economic burden of ventilator-associated pneumonia caused by Acinetobacter baumannii

作　　者：凌玲[1] 孙树梅[1] 汪能平[1] 向前[1] 周浩[1] 王茵茵[1] 

机构地区：[1]南方医科大学南方医院,广东广州510515

出　　处：《中国感染控制杂志》2013年第6期412-414,共3页Chinese Journal of Infection Control

摘　　要：目的探讨鲍曼不动杆菌所致呼吸机相关性肺炎(VAP)的危险因素及疾病经济负担。方法采用病例对照1∶1配对logistic回归,分析某院神经外科重症监护室33例鲍曼不动杆菌所致VAP的危险因素,比较两组患者住院天数、住院费用及药费情况。结果气管切开是导致鲍曼不动杆菌VAP的主要危险因素(P=0.005,OR=65.29)。病例组与对照组住院天数的中位数分别为48 d和23 d,经转换后,采用配对t检验,病例组住院天数显著高于对照组(t=6.237,P<0.001)。病例组患者住院总费用(中位数为19.84万元)和药费(中位数为9.72万元)均显著高于对照组(中位数分别为5.99万元、2.23万元),差异有统计学意义(均P<0.001);两组患者日均住院费用差异无统计学意义(P=0.085),而病例组日均药费(中位数为2 160.38元)显著高于对照组(中位数为1 321.10元),差异有统计学意义(P<0.001)。结论气管切开容易并发肺部感染;鲍曼不动杆菌是导致VAP的重要病原菌;肺部感染导致患者疾病经济负担增加。ObjectiveTo explore the risk factors and economic burden of ventilatorassociated pneumonia（VAP）caused by Acinetobacter baumannii （A.baumannii）.MethodsLogistic regression for 1∶1 matched casecontrol study was adopted to analyze risk factors for 33 cases of VAP caused by A. baumannii, length of hospital stay, hospitalization expense, and drug expense of two groups were compared. ResultsTracheotomy was the major risk factor for A. baumannii VAP（P=0.005，OR=65.29）. The median length of hospital stay in case group and control group were 48 and 23 days respectively. After adjusting, ttest showed that length of hospital stay in case group was significantly higher than that of control group（t=6.237，P＜0.001）.The total hospitalization expense and expense of drugs in case group were both higher than those of control group（median 198 400 yuan vs 59 900 yuan P＜0.001; 97 200 yuan vs 22 300 yuan,P＜0.001）,the average expense per hospitalization day between two groups was not significantly different（P=0.085）, but the average drug expense per hospitalization day in case group was significantly higher than that of control group（median 2 160.38 yuan vs 1 321.10 yuan， P＜0.001）.ConclusionPulmonary infection can be easily developed following tracheotomy, A. baumannii is the major pathogen for VAP; pulmonary infection can increase economic burden of patients.

关 键 词：鲍曼不动杆菌 呼吸机相关性肺炎 医院感染 危险因素 疾病负担 

分 类 号：R563.1[医药卫生—呼吸系统]