慢性阻塞性肺疾病急性加重期患者感染耐亚胺培南鲍曼不动杆菌的危险因素分析  

Risk factors for imipenem-resistant Acinetobacter baumannii infection in acute exacerbation of chronic obstructive pulmonary disease

作　　者：陈进永 许志明[1] 林荣繁 邓岳凤 CHEN Jin-yong;XU Zhi-ming;LIN Rong-fan;DENG Yue-feng(Department of Respiratory Medicine,Lianjiang People's Hospital,Lianjiang 524400,China)

机构地区：[1]广东省廉江市人民医院呼吸内科,广东廉江524400

出　　处：《广东医科大学学报》2020年第2期181-184,共4页Journal of Guangdong Medical University

基　　金：湛江市科技计划项目(No.2018B01064)。

摘　　要：目的分析慢性阻塞性肺疾病急性加重期(AECOPD)患者感染耐亚胺培南鲍曼不动杆菌(IRAB)的危险因素。方法AECOPD患者呼吸道分离的114株鲍曼不动杆菌(AB)分为IRAB(84株)组、敏感AB(ISAB,30株)组,用多因素Logistic回归分析IRAB感染的危险因素。结果IRAB组中头孢他啶、哌拉西林、头孢吡肟、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、左氧氟沙星、环丙沙星、阿米卡星耐药率及Ⅲ~Ⅳ级COPD明显高于ISAB组(P<0.01或0.05)。住院时间≥30 d、机械通气时间>7 d、入住ICU时间>7 d、使用替加环素或碳青霉烯类抗生素、Ⅲ~Ⅳ级COPD是感染IRAB的独立危险因素。结论AECOPD患者IRAB感染率较高,特别是Ⅲ~Ⅳ级COPD者。Objective To analyze the risk factors of imipenem-resistant Acinetobacter baumannii(IRAB)infection in acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 114 Acinetobacter baumannii(AB)isolates from respiratory tract of AECOPD patients were divided into IRAB(n=84)and imipenem-sensitive AB(ISAB,n=30)groups.Risk factors for IRAB infection were analyzed using multivariate logistic regression.Results Compared with ISAB group,drug resistance rates of ceftazidime,piperacillin,cefepime,cefoperazone/sulbactam,piperacillin/tazobactam,levofloxacin,ciprofloxacin and amikacin,and cases of grade III-IV COPD were increased in IRAB group(P<0.01 or 0.05).Hospitalization time≥30 days,mechanical ventilation>7 days,ICU stay>7 days,use of tegacyclin or carbapenem antibiotics,and grade III-IV COPD were independent risk factors for IRAB infection.Conclusion The infection rate of IRAB is higher in AECOPD patients,especially in grade III-IV COPD.

关 键 词：慢性阻塞性肺疾病 鲍曼不动杆菌 亚胺培南 危险因素 

分 类 号：R563.9[医药卫生—呼吸系统]