重症监护病房鲍氏不动杆菌致呼吸机相关性肺炎的危险因素分析及干预对策

发布时间：2018-12-24 12:23

【摘要】：目的多元回归分析重症监护病房(ICU)鲍氏不动杆菌(ABA)致呼吸机相关性肺炎的危险因素,制定相关干预对策。方法选择2013年3月-2016年3月医院ICU治疗ABA致呼吸机相关性肺炎患者126例进行研究,统计感染ABA的药敏性,并分析ICU ABA致呼吸机相关性肺炎发生的危险因素,进行统计分析。结果ABA对氨苄西林、庆大霉素的耐药率较高达90.00%以上,对亚胺培南和美罗培南最为敏感,耐药率均20.00%,其中85株ABA显示对≥3种抗菌药物耐药为泛耐药;单因素分析显示,ICU泛耐药ABA呼吸机相关性肺炎的发生与住院时间、机械通气方式、使用糖皮质激素、留置胃管、使用碳青霉烯类抗菌药物及使用≥3种抗菌药物呈明显相关性(χ2=20.292、10.414、7.524、7.810、9.760和11.635,P0.05);logistic回归模型分析显示,机械通气方式、留置胃管、使用≥3种抗菌药物是ICU泛耐药ABA呼吸机相关性肺炎发生的独立危险因素(OR=6.527、6.337、5.467,P0.05)。结论 ICU呼吸机相关性肺炎ABA泛耐药现象严重,机械通气方式、留置胃管、使用≥3种抗菌药物是其发生的独立危险因素,医护人员应避免ABA感染和耐药的进一步传播。
[Abstract]:Objective to analyze the risk factors of ventilator-associated pneumonia caused by Acinetobacter baumannii (ABA) in intensive care unit (ICU) by multiple regression analysis. Methods 126 patients with ventilator-associated pneumonia caused by ABA were treated with ICU from March 2013 to March 2016. The drug sensitivity of ABA infection was analyzed and the risk factors of ICU ABA induced ventilator-associated pneumonia were analyzed. Results the resistance rate of ABA to ampicillin and gentamicin was 90.00%, and was most sensitive to imipenem and meropenem, the resistance rate was 20.00%. 85 strains of ABA showed pan-resistance to more than 3 kinds of antimicrobial agents. Univariate analysis showed that ICU pan-resistant ABA ventilator-associated pneumonia was associated with duration of hospitalization, mechanical ventilation, use of glucocorticoid, indwelling of gastric tube, There was a significant correlation between carbapenes and 鈮，

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