多重耐药鲍曼不动杆菌血流感染危险因素分析

发布时间：2018-03-31 00:23

本文选题：鲍曼不动杆菌　切入点：多重耐药　出处：《中国感染与化疗杂志》2017年02期

【摘要】：目的探讨多重耐药(MDR)鲍曼不动杆菌血流感染的危险因素及影响鲍曼不动杆菌血流感染30 d预后的危险因素。方法采用病例对照的研究方法,回顾性分析2013年1月-2014年12月中国医科大学附属第一医院MDR鲍曼不动杆菌血流感染49例,以同时期敏感鲍曼不动杆菌血流感染29例作为对照,应用单因素分析及多因素logistic回归分析探讨MDR鲍曼不动杆菌血流感染的危险因素。将78例鲍曼不动杆菌血流感染患者按血培养标本采集后30 d内预后分为存活组(38例)和非存活组(40例),应用上述方法分析影响鲍曼不动杆菌血流感染30 d预后的危险因素。结果单因素分析发现,MDR鲍曼不动杆菌血流感染的危险因素包括:感染前应用碳青霉烯类药物、应用喹诺酮类药物、应用2类以上抗菌药物、接受机械通气、留置鼻胃管、留置中心静脉导管、入住ICU等;再进行logistic多因素回归分析,结果显示入住ICU(OR=7.118)、感染前应用2类以上抗菌药物(OR=8.073)是MDR鲍曼不动杆菌血流感染的独立危险因素。预后单因素分析结果提示影响鲍曼不动杆菌血流感染30 d预后的危险因素包括:入住ICU、机械通气、血培养提示MDR鲍曼不动杆菌感染等,再进行logistic多因素回归分析发现,MDR鲍曼不动杆菌感染(OR=5.837)、机械通气(OR=4.926)是影响鲍曼不动杆菌血流感染30 d预后的独立危险因素。结论感染前入住ICU、应用2类以上抗菌药物是MDR鲍曼不动杆菌血流感染的独立危险因素;MDR鲍曼不动杆菌感染、机械通气是影响鲍曼不动杆菌血流感染30 d预后的独立危险因素。
[Abstract]:Objective to investigate the risk factors of blood flow infection of Acinetobacter baumannii and the risk factors affecting the prognosis of 30 days after infection with MDR. Methods A case-control study was carried out. From January 2013 to December 2014, 49 patients with Acinetobacter baumannii blood stream infection in the first affiliated Hospital of China Medical University were retrospectively analyzed, and 29 patients with acinetobacter baumannii blood flow infection at the same time were compared. Single factor analysis and multivariate logistic regression analysis were used to study the risk factors of blood stream infection of Acinetobacter baumannii MDR. 78 patients with Acinetobacter baumannii blood stream infection were divided into survival group (n = 38) according to prognosis within 30 days after blood culture. The risk factors influencing the prognosis of Acinetobacter baumannii on 30 days were analyzed by using the above method. Results univariate analysis showed that the risk factors for the blood flow infection of Acinetobacter baumannii were as follows:. Before the use of carbapenems, Using quinolones, using more than 2 kinds of antibiotics, receiving mechanical ventilation, indwelling nasogastric tube, indwelling central venous catheter, staying in ICU and so on. The results showed that MDR was an independent risk factor for blood flow infection of Acinetobacter baumannii with the use of more than two kinds of antimicrobial agents before infection. The results of prognostic univariate analysis indicated that the prognosis of Acinetobacter baumannii was critical to the prognosis of 30 days of blood flow infection of Acinetobacter baumannii. Risk factors include: admission to ICU, mechanical ventilation, Blood culture suggests MDR Acinetobacter baumannii infection, Logistic multivariate regression analysis showed that the infection of Acinetobacter baumannii (OR5.837) and mechanical ventilation (OR4.926) were independent risk factors for 30 days prognosis of Acinetobacter baumannii blood stream infection. Conclusion the use of more than two kinds of antimicrobial agents before infection is an independent risk factor for the prognosis of Acinetobacter baumannii. It is an independent risk factor for MDR Acinetobacter baumannii blood stream infection. Mechanical ventilation is an independent risk factor for 30 days prognosis of Acinetobacter baumannii.
【作者单位】：中国医科大学附属第一医院感染科;
【基金】：辽宁省自然科学基金(2013021091)
【分类号】：R515.3

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