耐碳青霉烯类鲍曼不动杆菌血流感染患者危险因素及预后
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尹维佳

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R181.3+2R378.99

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Risk factors and prognosis of patients with bloodstream infection due to carbapenemresistant Acinetobacter baumannii
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    摘要:

    目的探讨住院患者血流感染耐碳青霉烯类鲍曼不动杆菌(CRAB)的危险因素及预后。方法采用病例对照研究,回顾性收集某院2010—2013年CRAB血流感染患者163例,并以同期68例对碳青霉烯类敏感的鲍曼不动杆菌(CSAB)血流感染患者作为对照,进行危险因素及预后分析。结果CRAB血流感染的独立危险因素是感染前入住重症监护病房(ICU)[OR及OR95%CI:1.27(5.55~22.89)]及入住过急诊室[OR及OR95%CI:3.57(1.67~7.62)]。鲍曼不动杆菌(AB)血流感染患者28 d生存率CRAB为66.17%,而CSAB为96.95%,CRAB组患者的生存率低于CSAB组(χ2=15.71,P<0.001)。影响AB血流感染预后的独立危险因素包括感染CRAB(HR95%CI:3.01~67.28)、血液病(HR95%CI:3.77~25.97)、心功能不全(HR95%CI:2.10~20.41)、入住ICU(HR95%CI:1.01~5.28)及年龄(HR95%CI:1.01~1.04)。结论感染前入住ICU以及入住过急诊室是CRAB血流感染的危险因素,CRAB血流感染是影响患者预后的危险因素。

    Abstract:

    ObjectiveTo explore the risk factors and prognosis of hospitalized patients with bloodstream infection due to carbapenemresistant Acinetobacter baumannii(CRAB).Methods163 patients with CRAB bloodstream infection from 2010 to 2013 were conducted retrospective casecontrol study, 68 patients with bloodstream infection due to carbapenemsusceptible Acinetobacter baumannii(CSAB) during the same period were as control group.ResultsThe independent risk factors for CRAB bloodstream infection were stay in intensive care unit(ICU) (OR,1.27[95%CI,5.55-22.89]) and emergency department(OR,3.57 [95%CI,1.67-7.62]) before infection. Patients with CRAB bloodstream infection had lower 28day survival rate than those with CSAB bloodstream infection(66.17% vs 96.95%,χ2=15.71,P<0.001). The independent risk factors for influencing prognosis of Acinetobacter baumannii bloodstream infection were infection of CRAB (HR 95% CI,3.01-67.28), blood disease(HR 95%CI, 3.77-25.97), cardiac insufficiency(HR 95%CI,2.10-20.41), stay in ICU(HR 95%CI, 1.01-5.28),and age(HR 95%CI,1.01-1.04).ConclusionThe independent risk factors for CRAB bloodstream infection are stay in ICU and emergency department before infection, CRAB bloodstream infection is risk factor for influencing prognosis of patients.

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黄文治,乔甫,王妍潼,等.耐碳青霉烯类鲍曼不动杆菌血流感染患者危险因素及预后[J]. 中国感染控制杂志,2015,14(10):668-671. DOI:10.3969/j. issn.1671-9638.2015.10.005.
HUANG Wenzhi, QIAO Fu, WANG Yantong, et al. Risk factors and prognosis of patients with bloodstream infection due to carbapenemresistant Acinetobacter baumannii[J]. Chin J Infect Control, 2015,14(10):668-671. DOI:10.3969/j. issn.1671-9638.2015.10.005.

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  • 收稿日期:2015-07-08
  • 最后修改日期:2015-09-22
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  • 在线发布日期: 2015-10-30
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