危重患者泛耐药鲍氏不动杆菌定植与感染预防控制研究  

Prevention and control of pandrug-resistant Acinetobacter baumannii colonization and infections in critically ill patients

作　　者：樊楚明[1] 杨欣悦[1] 任靖宇[1] 张洪波[1] 茹今 陈庆宁[2] 

机构地区：[1]云南省第一人民医院重症医学科,云南昆明650032 [2]云南省第一人民医院皮肤科,云南昆明650032

出　　处：《中华医院感染学杂志》2016年第2期260-262,共3页Chinese Journal of Nosocomiology

基　　金：云南省科技厅与昆明医科大学联合基金资助项目(2014FZ066)

摘　　要：目的研究住院危重患者泛耐药鲍氏不动杆菌的定植和感染,加强预防控制,降低其定植率与感染率。方法选择2013年1月-2015年3月泛耐药鲍氏不动杆菌定植与感染的住院危重患者150例为感染组,选择同期未感染泛耐药鲍氏不动杆菌的住院危重患者150例为对照组,比较两组患者的临床资料,分析泛耐药鲍氏不动杆菌的分布及科室来源;采用SPSS20.0软件对数据进行统计分析。结果感染组患者的ICU住院时间(33.82±13.74)d,APACEⅡ评分为(20.13±6.58)分,其中有98例行机械通气占65.33%,死亡51例病死率34.00%,其各方面均明显高于对照组,差异有统计学意义(P<0.05);感染患者共分离出162株泛耐药鲍氏不动杆菌,主要分布于痰液中;150例泛耐药鲍氏不动杆菌感染患者中有44例为院外带入,其余以急诊科为主。结论住院危重患者泛耐药鲍氏不动杆菌的定植和感染与患者的ICU住院时间、APACEⅡ评分、机械通气等有关,应加强管理,降低其定植率和感染率。OBJECTIVE To explore the prevalence of pandrug-resistant Acinetobacter baumannii colonization and infections in the critically ill patients and strengthen the prevention and control so as to reduce the incidence of colonization and infections.METHODS Totally 150 critically ill patients with pandrug-resistant A.baumannii colonization and infections who were hospitalized from Jan 2013 to Mar 2015 were chosen as the infection group,and 150 critically ill patients without pandrug-resistant A.baumannii infection who were hospitalized during the same period were set as the control group.The distribution and sources of departments of the pandrug-resistant A.baumannii strains were observed,and the statistical analysis of data was performed with the use of SPSS20.0software.RESULTS The length of ICU stay of the infection group was（33.82±13.74）days,significantly longer than that of the control group;the APACEⅡ score of the infection group was（20.13±6.58）points,significantly higher than that of the control group;the proportion of the patients undergoing mechanical ventilation was 65.33%（98cases）in the infection group,significantly higher than that in the control group;the mortality rate of the infection group was 34.00%（51cases）,significantly higher than that of the control group（P〈0.05）.A total of 162 strains of pandrug-resistant A.baumannii were isolated from the patients with infections,most of which were isolated from the sputum specimens.Of the 150 patients with pandrug-resistant A.baumannii infections,44 had the infections before the admission to the hospital,and the patients of the emergency department were dominant among the rest of the patients.CONCLUSION The pandrug-resistant A.baumannii colonization and infections in the critically ill patients are associated with the length of ICU stay,APACEⅡscore,and mechanical ventilation.It is necessary to strengthen the management so as to reduce the incidence of the colonization and infections.

关 键 词：危重患者 泛耐药鲍氏不动杆菌 定植 感染 

分 类 号：R378[医药卫生—病原生物学]