耐碳青霉烯类鲍曼不动杆菌血流感染的危险因素及预后的评估指标
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南昌大学第一附属医院感染二科, 江西 南昌 330006

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通讯作者:

程娜  E-mail: chengnah@sina.com

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+2;R515.3]]>

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江西省青年科学基金资助项目(20181BAB215033)


Risk factors and prognostic indicators for carbapenem-resistant Acinetobacter baumannii bloodstream infection
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The Second Department of Infection, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China

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    摘要:

    目的 探讨耐碳青霉烯类鲍曼不动杆菌(CRAB)血流感染的危险因素,并评估降钙素原(PCT)、C反应蛋白(CRP)对CRAB血流感染患者预后的预测价值。 方法 以2013年1月-2020年8月某院确诊鲍曼不动杆菌血流感染患者为研究对象,依据对碳青霉烯类的耐药性分为耐药组(CRAB组)与敏感组(CSAB组),比较两组患者的临床资料;根据预后的不同将CRAB患者分为预后良好组与预后不良组,比较两组患者在确诊后48 h内的PCT、CRP水平,并通过受试者工作特征曲线(ROC曲线)评估其对患者预后的预测价值。 结果 共纳入64例鲍曼不动杆菌血流感染患者,包括CRAB组43例与CSAB组21例。使用抗菌药物>7 d是CRAB血流感染的独立危险因素(OR=6.198,95%CI:1.280~30.023)。43例CRAB血流感染患者中预后良好组13例,预后不良组30例。ROC曲线显示,PCT、CRP以及PCT联合CRP预测CRAB血流感染患者不良预后的曲线下面积分别为0.829(95%CI:0.658~1.000)、0.800(95%CI:0.610~0.990)、0.895(95%CI:0.751~1.000)。 结论 使用抗菌药物>7 d是CRAB血流感染的危险因素,血清PCT、CRP水平对CRAB血流感染患者的预后有预测价值。

    Abstract:

    Objective To evaluate the risk factors for carbapenem-resistant Acinetobacter baumannii bloodstream infection (CRAB-BSI), evaluate the prognostic value of procalcitonin (PCT) and C-reactive protein (CRP) in patients with CRAB-BSI. Methods Patients with CRAB-BSI diagnosed in a hospital from January 2013 to August 2020 were as studied objects, according to their resistance to carbapenem, they were divided into drug-resistant group (CRAB group) and sensitive group (carbapenem-sensitive Acinetobacter baumannii, CSAB group), clinical data of two groups of patients were compared; according to the different prognosis, CRAB patients were subdivided into good prognosis group and poor prognosis group, levels of PCT and CRP within 48 hours after diagnosis of two groups of patients were compared, and predictive value of PCT and CRP for the prognosis was evaluated by receiver operating characteristic (ROC) curve. Results A total of 64 patients with CRAB-BSI were included in study, including 43 cases in CRAB group and 21 cases in CSAB group. Antimicrobial use>7 days was an independent risk factor for CRAB-BSI (OR=6.198, 95%CI: 1.280-30.023). Among 43 patients with CRAB-BSI, 13 cases had a good prognosis and 30 had a poor prognosis. ROC showed that the areas under the curve of PCT, CRP and PCT combined with CRP in predicting the adverse prognosis of patients with CRAB-BSI were 0.829 (95%CI: 0.658-1.000), 0.800 (95%CI: 0.610-0.990) and 0.895 (95%CI: 0.751-1.000) respectively. Conclusion Antimicrobial use>7 days is a risk factor for CRAB-BSI, levels of serum PCT and CRP have predictive value for the prognosis of patients with CRAB-BSI.

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石江龙,程娜,向天新,等.耐碳青霉烯类鲍曼不动杆菌血流感染的危险因素及预后的评估指标[J]. 中国感染控制杂志,2021,(12):1082-1087. DOI:10.12138/j. issn.1671-9638.20218185.
Jiang-long SHI, Na CHENG, Tian-xin XIANG, et al. Risk factors and prognostic indicators for carbapenem-resistant Acinetobacter baumannii bloodstream infection[J]. Chin J Infect Control, 2021,(12):1082-1087. DOI:10.12138/j. issn.1671-9638.20218185.

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  • 收稿日期:2020-11-02
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  • 在线发布日期: 2024-04-26
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