鲍曼不动杆菌感染患者的特征及血流感染预后的危险因素研究

发布时间：2018-06-27 18:32

本文选题：鲍曼不动杆菌 + 耐药性　；参考：《暨南大学》2016年硕士论文

【摘要】：目的:分析鲍曼不动杆菌感染患者的临床特点,了解该菌的流行趋势及耐药性变迁,为临床合理选用抗菌药物和医院控制感染提供参考;同时探讨鲍曼不动杆菌血流感染预后的危险因素,为降低鲍曼不动杆菌血流感染的发生率及死亡率提供临床依据。方法:收集2010年1月-2015年12月暨南大学附属第一医院鲍曼不动杆菌感染1058例及鲍曼不动杆菌血流感染98例患者,对其临床资料进行回顾性分析。根据血流感染患者30天预后分为死亡组(39例)和生存组(59例),运用单因素分析和多因素logistic回归分析确定影响鲍曼不动杆菌血流感染预后的危险因素。结果:1、1058例患者中:标本类型主要是呼吸道和血液标本;病区主要分布在ICU和呼吸内科;对临床常用的抗菌药物耐药率在逐年上升,普遍在50%以上,其中对美罗培南和亚胺培南耐药率分别为57.8%、70.8%。2、98例血流感染患者中:平均年龄(63.57±17.34)岁,平均住院时间(35.55±42.86)天,病区主要分布在ICU和心血管科。大部分患者合并有呼吸系统及心脑血管疾病。3、单因素分析结果表明,APACHE II评分、有创操作、使用广谱抗菌药物及免疫抑制剂、细菌耐药性、合并其他部位或细菌感染、合并呼吸系统疾病、白细胞总数、血液透析(P0.05)是鲍曼不动杆菌血流感染预后的危险因素。多因素logistic回归分析表明,APACHE II评分、细菌耐药性(P0.10)是鲍曼不动杆菌血流感染的独立危险因素。结论:1、鲍曼不动杆菌感染的发病率、耐药率在逐年升高。标本类型主要是呼吸道标本,病区主要分布在ICU。2、鲍曼不动杆菌引起的血流感染患者病情危重、死亡率高,与预后相关的独立危险因素是APACHE II评分、细菌耐药性。
[Abstract]:Objective: to analyze the clinical characteristics of Acinetobacter baumannii infection and to find out the epidemic trend and drug resistance of Acinetobacter baumannii so as to provide reference for the rational selection of antimicrobial agents and nosocomial infection control. To explore the prognostic factors of blood stream infection of Acinetobacter baumannii and to provide clinical basis for reducing the incidence and mortality of blood stream infection of Acinetobacter baumannii. Methods: from January 2010 to December 2015, 1058 patients with Acinetobacter baumannii infection and 98 patients with Acinetobacter baumannii blood stream infection in the first affiliated Hospital of Jinan University were collected and their clinical data were retrospectively analyzed. According to the prognosis of 30 days, the patients were divided into death group (39 cases) and survival group (59 cases). Univariate analysis and multivariate logistic regression analysis were used to determine the risk factors influencing the prognosis of blood stream infection of Acinetobacter baumannii. Results among 1058 patients, the types of specimens were mainly respiratory tract and blood, the main areas were ICU and respiratory department, and the rate of drug resistance to antibiotics commonly used in clinic was increasing year by year, which was more than 50%. The drug resistance rates to meropenem and imipenem were 57.8% and 70.8%, respectively. The mean age and hospital stay were (63.57 卤17.34) years and (35.55 卤42.86) days, respectively. Most of the patients had respiratory and cardio-cerebrovascular diseases .3.The results of univariate analysis showed that Apache II score, invasive operation, use of broad-spectrum antimicrobial agents and immunosuppressants, bacterial resistance, combined with other sites or bacterial infections, Respiratory diseases, leukocyte count and hemodialysis (P0.05) were the prognostic factors of Acinetobacter baumannii. Multivariate logistic regression analysis showed that Apache II score and bacterial resistance (P0.10) were independent risk factors for blood flow infection of Acinetobacter baumannii. Conclusion the incidence and resistance rate of Acinetobacter baumannii infection increased year by year. The main types of specimens were respiratory tract specimens, the main area of disease was ICU.2.Acinetobacter baumannii caused by blood stream infection patients had serious condition and high mortality. The independent risk factors related to prognosis were Apache II score and bacterial resistance.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R446.5

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