ICU耐碳青霉烯类抗菌药物鲍曼不动杆菌肺部感染危险因素分析

发布时间：2018-11-01 15:55

【摘要】：目的:探讨重症监护室(ICU)耐碳青霉烯类抗菌药物鲍曼不动杆菌(CRAb)肺部感染的危险因素。方法:采用回顾性研究方法,收集宝鸡市中心医院ICU 2012年6月-2014年6月鲍曼不动杆菌(Ab)肺部感染患者105例,其中CRAb组患者81例,对碳青霉烯类抗菌药物敏感Ab(CSAb)组患者24例,对发生CRAb肺部感染的危险因素采用单因素分析及多因素Logistic多元回归分析。结果:单因素分析发现,分离出Ab前ICU住院天数、ICU总住院天数、呼吸衰竭、低蛋白血症、机械通气、机械通气天数、分离出Ab前15 d内碳青霉烯类抗菌药物的使用及联合应用抗菌药物、C反应蛋白检测异常、降钙素原检测异常与ICU CRAb肺部感染的发生显著相关;多因素分析显示,分离出Ab前ICU住院天数、分离出Ab前15 d内使用碳青霉烯类抗菌药物、分离出Ab前行机械通气、分离出Ab前患者低蛋白血症为Ab感染的独立危险因素。结论:入住ICU的高危患者,应结合危险因素,尽早采取措施,合理防治CRAb肺部感染。
[Abstract]:Objective: to investigate the risk factors of pulmonary infection of acinetobacter baumannii (CRAb) (Acinetobacter baumannii) in (ICU) in intensive care unit. Methods: a retrospective study was conducted to collect 105 patients with (Ab) pulmonary infection of Acinetobacter baumannii from June 2012 to June 2014 in Baoji Central Hospital, including 81 patients in CRAb group. Single factor analysis and multivariate Logistic regression analysis were used to analyze the risk factors of pulmonary infection in 24 patients with carbapenem sensitive Ab (CSAb) group. Results: univariate analysis showed that ICU hospitalization days, total ICU hospitalization days, respiratory failure, hypoproteinemia, mechanical ventilation days were separated before Ab. The use and combination of carbapenem antibiotics in the first 15 days before Ab were isolated. C-reactive protein was abnormal and procalcitonin was significantly correlated with the occurrence of pulmonary infection in ICU CRAb. Multivariate analysis showed that the days of hospitalization of ICU before Ab, the use of carbapenem antibiotics within 15 days before Ab, the mechanical ventilation before Ab, and the hypoproteinemia of patients before Ab were independent risk factors of Ab infection. Conclusion: high-risk patients admitted to ICU should take measures to prevent and treat pulmonary infection of CRAb as soon as possible in combination with risk factors.
【作者单位】：西安交通大学医学院第一附属医院;宝鸡市中心医院;
【分类号】：R969.1

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