| 李娜,刘晓霞.多重耐药鲍曼不动杆菌感染的相关危险因素分析[J].安徽医药,2020,24(1):197-201. |
| 多重耐药鲍曼不动杆菌感染的相关危险因素分析 |
| Analysis of related risk factors of multidrug?resistant acinetobacter baumannii infection |
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| DOI：10.3969/j.issn.1009?6469.2020.01.050 |
| 中文关键词: 鲍曼不动杆菌 抗药性，多种，细菌 危险因素 合理用药 |
| 英文关键词: Acinetobacter baumannii Drug resistance,multiple,bacterial Risk factors Rational drug use |
| 基金项目:新疆生产建设兵团工业科技计划项目( 2015AB034) |
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| 中文摘要: |
| 目的探讨多重耐药鲍曼不动杆菌( MDRAB)的相关危险因素，为临床合理用药提供依据。方法采用回顾性分析方法调查 2016年 1月至 2017年 12月新疆生产建设兵团系统内 13家医疗机构的 1 359例鲍曼不动杆菌感病人的病例资料，得出感染 MDRAB的危险因素，并通过多元 logistic回归分析发现独立危险因素。结果 1 359例鲍曼不动杆菌感染病人中老年人(75~99岁)居多有 664例(占 48.86%)科室分布以内科为主有 916例(占 67.40%)感染部位主要分布在呼吸系统有 1 129例(占 83.08%)标本类型主要为痰液有11，01例(占 81.02%)多重耐药组死亡 265例，病，死率 35.71%；非多重耐药组死亡 134例，病死率 21.72%，。两组比较差异有统计学意义( χ2＝31.819，P，＝0.000)。单因素分析结果显示:性别、长期卧床、两种以上基础疾病、手术、侵入操作、入住 ICU、心功能不全、肝功能不全、肾功能不全、肺功能不全、合并其它细菌感染、合并真菌感染、免疫调节剂使用、喹诺酮类使用、糖肽类使用、碳青霉烯类使用、加酶抑制剂使用是 MDRAB感染的危险因素。多因素分析结果显示:是否入住 ICU、侵入操作、喹诺酮类使用、碳青霉烯类使用、加酶抑制剂使用是 MDRAB感染的独立危险因素。结论 MDRAB给临床治疗带来了极大的挑战，早期干预危险因素及合理使用抗菌药物有助于减少 MDRAB的发生率。 |
| 英文摘要: |
| Objective To explore the risk factors of multidrug resistant Acinetobacter baumannii(MDRAB)，and to provide evi? dence for rational drug use in clinic.Methods The data of 1359 patients with Acinetobacter baumannii(AB)infection in 13 med? ical institutions of the corps system from January 2015 to December 2016 were investigated by retrospective analysis method，and the risk factors of MDRAB infection were obtained.The independent risk factors were found through multiple logistic regressionanalysis.Results In 1359 cases of medical records，the majority of patients with AB infection were the elderly(75?99 years old)(48.86%)，the department distribution was mainly internal medicine(67.40%)， the infection site was mainly respiratory system(83.08%)the specimen type was mainly sputum(81.02%)and the mortality rate of multidrug resistance group was significantly higherthant，hat of non?multidrug resistance group(P＝0.000).，Single factor analysis showed that gender，long?term bedridden，two or more basic diseases，surgery，invasive procedures，ICU admission，cardiac insufficiency，hepatic insufficiency，renal insufficiency， pulmonary dysfunction，concomitant with other bacterial infection，the combining fungal infections，immune regulator use，quinolone use，sugar peptide use，carbapenem use，plus enzyme inhibitor use were MDRAB infection risk factors.The results of multivariate analysis showed that the presence of ICU，invasive procedures，quinolone use，carbapenem use and enzyme inhibitor use were inde? pendent risk factors for MDRAB infection.Conclusion MDRAB poses great challenges to clinical treatment.Early intervention ofrisk factors and rational use of antimicrobial agents can help reduce the incidence of MDRAB. |
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