多药耐药鲍氏不动杆菌感染的危险因素与临床特征分析  

Analysis of risk factors and clinical features of multidrug resistant Acinetobacter baumannii causing infections

作　　者：孙成栋[1] 李真[1] 王燕[1] 张雪梅[1] 白爱华[1] 

机构地区：[1]北京积水潭医院感染疾病科,北京100035

出　　处：《中华医院感染学杂志》2015年第20期4577-4579,共3页Chinese Journal of Nosocomiology

基　　金：北京市科技重大基金资助项目(京科技发〔2002〕641)

摘　　要：目的研究多药耐药鲍氏不动杆菌(MDRAB)感染的危险因素及其临床特征,为临床提供预防与控制依据。方法收集2011年1月-2014年1月527例鲍氏不动杆菌(ABA)感染患者的临床资料,其中MDRAB感染的234例患者为病例组,非MDRAB感染的293例患者为对照组,对两组患者的年龄、性别、机械通气、抗菌药物使用、住院天数、侵入性操作、血清白蛋白等进行对比分析,查找MDRAB医院感染危险因素。结果 527例ABA感染患者中,MDRAB感染患者234例,MDRAB感染率为44.40%;单因素分析显示,两组患者感染前急性生理和慢性健康评分标准Ⅱ(APACHEⅡ)、使用呼吸机、免疫抑制剂时间、血清白蛋白、使用碳青霉烯类抗菌药物以及抗菌药物使用≥3种,差异均有统计学意义(P<0.05);多因素logistic回归分析结果显示,APACHEⅡ、抗菌药物联合使用≥3种及机械通气是MDRAB感染患者发生医院感染的独立危险因素。结论 APACHEⅡ、抗菌药物联合使用≥3种及机械通气在MDRAB的产生和传播中起重要作用;提高机体免疫功能、合理的联合使用抗菌药物、减少机械通气时间对减少MDRAB感染具有重要意义。OBJECTIVE To study the risk factors and clinical features of multidrug resistant Acinetobacter bauman‐nii（MDRAB） so as to provide references for prevention and control .METHODS The clinical data of 234 cases in‐fected by MDRAB from Jan .2011 to Jan .2014 were collected .The 234 cases infected by MDRAB were chosen as case group ,other 293 cases infected by common A .baumannii were selected as the control group .Age ,sex ,me‐chanical ventilation ,the use of antibiotics ,duration of hospitalization ,invasive operation ,and serum albumin were compared and analyzed to find risk factors of hospital infections of MDRAB .RESULTS Totally 234 strain of MDRAB were detected in 527 cases infected by ABA ,and the detection rate was 44 .40% .Single factor analysis showed that APACHEⅡI ,ventilator ,immunosuppressant time ,serum albumin ,the use of carbapenem antibiot‐ics and to the use of more than three kinds of antibiotics were risk factors and the difference was significant （P〈0 .05） .Non conditional multi factors logistic regression analysis showed the APACHEⅡ ,use of more than three kinds of antibiotics and mechanical ventilation were the independent risk factors of hospital infections of MDRABM .CONCLUSION APACHEⅡ ,more than three kinds of antibiotics and mechanical ventilation play im‐portant roles in MDRAB infections .Improvement of the body′s immune function ,reasonable combination of anti‐biotics and cutting of mechanical ventilation time are important for controlling the infections of MDRAB .

关 键 词：多药耐药 鲍氏不动杆菌 医院感染 危险因素 

分 类 号：R378[医药卫生—病原生物学]