多药耐药鲍氏不动杆菌医院感染的危险因素分析  

Risk factors for multidrug-resistant Acinetobacter baumannii nosocomial infection

作　　者：沈月娟[1] 杨文红[1] 陈玲玲[1] 施敏骅[1] 

机构地区：[1]苏州大学附属第二医院呼吸科,江苏苏州215000

出　　处：《中华医院感染学杂志》2017年第1期32-34,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金项目(81272610);江苏省苏州市科技发展计划基金资助项目(SYS201467)

摘　　要：目的分析多药耐药鲍氏不动杆菌(AB)医院感染的危险因素,为预防其医院感染提供依据。方法采用回溯性研究方法,选取医院2012年1月-2015年12月86例AB医院感染患者为研究对象,收集可能的危险因子;根据是否发生多药耐药AB医院感染将患者分为多药耐药组和非多药耐药组,对导致医院感染的危险因素进行单因素、多因素logistic分析。结果多药耐药AB医院感染61例,占70.93%,非多药耐药AB医院感染25例,占29.07%,且多药耐药AB医院感染发生例数呈逐年增加趋势;logistic多因素回归分析结果显示,多药耐药AB医院感染的危险因素包括感染前住院天数(OR=1.11,P<0.05)、支气管镜检查(OR=5.83,P<0.05)、使用头孢他啶(OR=4.29,P<0.05)和头孢匹罗(OR=3.73,P<0.05)。结论感染前住院天数、支气管镜检查、头孢他啶和头孢匹罗的使用是多药耐药AB感染的危险因素;加强对危重患者的医疗照护,减少患者住院天数,完善支气管镜的清洁消毒,规范抗菌药物的使用,降低多药耐药AB感染风险。OBJECTIVE To explore the risk factors for multidrug-resistant Acinetobacter baumannii （MRAB） noso- comial infection so as to provide guidance for prevention of the nosocomial infection. METHODS By means of retro- spective study, a total of 86 patients with A. baumannii nosocomiaL infection who were treated in the hospital from Jan 2012 to Dec 2015 were recruited as the study objects, the possible risk factors were collected. The enrolled pa- tients were divided into the multidrug-resistant group and the non-multidrug-resistant group according to the status of incidence of MRAB nosocomial infection. The univariate, multivariate logistic analysis was performed for the risk factors for the nosocomial infection. RESULTS Totally 61 patients had the MRAB nosocomial infection, ac- counting for 70.93%;25 patients had non-MRAB nosocomial infection, accounting for 29.07% the number of cases of MRAB nosocomial infection was increased year by year. The multivariate logistic regression analysis showed that the risk factors for the MRAB nosocomial infection included the hospitalization duration before infec- tion （OR= 1.11 ,P〈0.05）, bronchoscopy （OR= 5.83, P〈0.05）, and use of eeftazidime （OR=4.29, P%0.05） and cefpirome （OR-3.73,P〈0.05）. CONCLUSION The risk factors for the MRAB nosocomial infection include the hospitalization duration before infection, bronchoscopy, and use of ceftizidime and cefpirome. It is necessary to strengthen the medical care of the critically ill patients, shorten the hospitalization duration, improve the cleaning and disinfection of bronchoscopes, and reasonably use antibiotics so as to reduce the risk of MRAB infection.

关 键 词：多药耐药鲍氏不动杆菌 医院感染 支气管镜 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]