鲍曼不动杆菌的临床分佈及多重耐药危险因素分析

Analysis of clinical distribution and risk factors of multi-drug resistant of Acinetobacter baumannii

目的鲍曼不动杆菌是重要的医院获得性感染的病原菌。多重耐药(MDR)鲍曼不动杆菌感染常与住院时间长,住院花费多,病死率高相关。探讨我院鲍曼不动杆菌临床分布和MDR危险因素。方法收集2010年1月-2012年12月我院分离出的鲍曼不动杆菌住院患者病例,分析其分佈及耐药情况,并分析MDR危险因素。结果共收集鲍曼不动杆菌感染病例500例,MDR组患者440例,非MDR组患者60例,科室分佈以心外科最多,占47.5%,标本分佈以下呼吸道标本最多,占84.8%。MDR独立危险因素有2个:年龄>70岁(OR 0.871,95%CI 0.447-1.698,P=0.037)和住院时间>50 d(OR 0.695,95%CI 0.325-1.489,P=0.046)。结论 MDR鲍曼不动杆菌感染多发生于心外科,以肺部感染最为多见。年龄>70岁,住院时间>50d患者易发生MDR鲍曼不动杆菌感染,应予以重视。

Objective To study the clinical distribution and the MD-RAB in our hospital and the risk factors. Methods The clinical data of all patients who were diagnosed as nosocomial MD-RAB infections were retrospectively analyzed in our hospital from 2010 to 2012. Results The study selected a total of 500 patients with Acinetobacter baumannii infection,including 440 cases of MD-RAB and 60 cases of non-MD-RAB. The department of heart surgery took the most（ 47. 5%）. The most common specimen was lower respiratory tract（ 84. 8%）. The independent risk factors were age 〉70（ OR 0. 871,95% CI 0. 447- 1. 698,P = 0. 037） and the duration of hospital stay 〉50d（ OR 0. 695,95% CI 0. 325- 1. 489,P = 0. 046）. Conclusion Infection caused by A. baumannii often occurs in the department of heart surgery. Pulmonary infection is the most common situation. The patients who were older than 70 and their duration of hospital stay longer than 50 days should be paid more attention.