替加环素不敏感鲍曼不动杆菌所致感染的相关特征和危险因素

Infections caused by acinetobacter Baumannii with reduced susceptibility to tigecycline: associated features and risk factors

目的:探讨替加环素不敏感鲍曼不动杆菌所致感染患者的相关特征及可能的危险因素。方法:回顾性分析2013年1月至2016年12月天门市第一人民医院诊治的替加环素不敏感鲍曼不动杆菌感染患者与替加环素敏感菌感染患者的相关暴露情况,采用Logistic回归分析替加环素不敏感鲍曼不动杆菌感染的影响因素。结果:替加环素不敏感组患者对替加环素、β内酰胺类、碳青霉烯类抗生素的暴露率高于替加环素敏感组,P<0.05;替加环素不敏感组患者在细菌培养之前ICU入住时间、近期手术史、降钙素原方面暴露率高于替加环素敏感组,P<0.05;患者细菌培养之前ICU入住时间、碳青霉烯类药物、喹诺酮类药物暴露可能与发生替加环素不敏感鲍曼不动杆菌感染有关,P<0.05。结论:入住ICU、碳青霉烯类药物、喹诺酮类药物暴露可能与患者发生替加环素不敏感鲍曼不动杆菌感染有关。

Objective： To investigate the associated features and risk factors of infections caused by acinetobacter Baumannii with reduced susceptibility to tigecycline. Methods： Retrospective analysis was conducted for the associated exposure features in patients with tigecyclinesusceptible acinetobacter Bacteremia infections（the control group） and tigecycline non-susceptible acinetobacter bacteremia infections（the case group） from January 2013 to December 2016 in the First People＇s Hospital of Tianmen City. Logistic regression was conducted to find out the risk factors leading to infections caused by acinetobacter Baumannii with reduced susceptibility to tigecycline. Results： The case group showed higher exposure percents in tigecycline, beta-lactam antibiotics and carbapenems as well as ICU stay in days before culture, recent surgery and PCT（P〈0.05）. Multivariate analysis showed that ICU stay in days before culture, exposure to carbapenems, and recent exposure to quinolones were significantly associated with tigecycline non-susceptible acinetobacter bacteremia（P〈0.05）. Conclusion： ICU stay, exposure to carbapenems, and recent exposure to quinolones were possibly associated with tigecycline non-susceptible acinetobacter bacteremia.