泛耐药鲍氏不动杆菌感染病例死亡危险因素分析

Risk factors associated with death attributable to pandrug-resistant Acinetobacter baumannii infections

目的了解泛耐药鲍氏不动杆菌(MDRAB)感染病例的临床特征,分析其感染病例死亡的危险因素。方法回顾性分析医院2007年4月-7月出现的53例MDRAB感染患者临床特征,采用logistic逐步回归分析法对19例死亡病例和34例非死亡病例的危险因素,包括患者APACHEⅡ评分、呼吸机应用、三代头孢菌素和β-内酰胺抑制剂药物治疗史、住院时间、静脉置管、介入性诊疗措施进行比较。结果 53例MDRAB感染的病例中死亡19例,占35.8%;非死亡病例34例,占64.2%,在APACHEⅡ评分(P=0.0036,OR值1.2448)与大静脉置管应用(P=0.005,OR值0.015)差异有统计学意义(P<0.01)。结论 APACHEⅡ评分较高MDRAB感染患者死亡率高,应用大静脉置管的相关治疗措施可能利于改善MDRAB感染患者预后。

OBJECTIVE To observe the clinical characteristics of the cases with pandrug-resistant Acinetobacter bau- mannii infections and identify the risk factors associated with death. METHODS A retrospective study was conducted in the hospital from Apt to Jul 2007, fifty-three patients who had been diagnosed with MDRAB infec- tions were enrolled in the research, then the logistic regression analysis was performed to analyze the risk factors of 19 death cases and 34 survival cases, including APACHE-Ⅱ score, use of ventilator, history of treatment with third-generation cephalosporin or β-lactamase inhibitors, hospital stay, intravenous intubation, and interventional therapy. RESULTS Of 53 cases of patients with MDRAB infection, 19 cases died, accounting for 35.8%, and 34 cases survived, account for 64.2 %. The difference in the APACHE Ⅱ score （P= 0. 0036, OR=1. 2448） or the central venous catheterization （P 0. 005,OR=0. 015） was statistically significant （P〈0.01）. CONCLUSION Among patients who have MDRAB infections, a higher APACHE Ⅱ score could prognosticcate a higher montality rate, howere, central ceneus catheter of intencentional therapy may potentially clecrease the montality of MDRAB infections.