住院患者耐碳青霉烯鲍曼不动杆菌下呼吸道感染的危险因素分析

Risk Factors Analysis of Hospitalized Patients with Lower Respiratory Infection due to Carbapenem-resistant Acinetobacter Baumannii

目的:分析住院患者耐碳青霉烯鲍曼不动杆菌(carbapenem-resistant Acinetobacter baumannii,CRAb)下呼吸道感染的危险因素。方法:采用回顾性研究方法,收集2017年1月-2018年6月鲍曼不动杆菌下呼吸道感染住院患者共108例,其中对碳青霉烯抗菌药物耐药的Ab感染患者63例,对碳青霉抗生素药物敏感的Ab(carbapenem-sensitive Acinetobacter baumannii,CSAb)感染患者45例。对CRAb下呼吸道感染的危险因素进行单因素和多因素分析。结果:单因素分析显示,血清白蛋白<35 g/L、感染前入住ICU≥3 d、脑外伤、机械通气、深静脉置管及联合使用抗生素药物与下呼吸道感染CRAb显著相关(P<0.05);多因素Logistic回归分析显示,血清白蛋白<35 g/L、感染前入住ICU≥3 d、深静脉置管及联合使用抗生素药物为CRAb下呼吸道感染的独立危险因素(P<0.05)。结论:针对耐碳青霉烯鲍曼不动杆菌下呼吸道感染的危险因素,应对高危住院患者采取措施,合理防治。

Objective:To analyze the risk factors of hospitalized patients with lower respiratory infection due to carbapenem-resistant Acinetobacter baumannii(CRAb).Method:The univariate analysis and multivariate Logistic regression analysis were conducted with the method of case-control study,in which the clinical data of 108 cases of lower respiratory infection of CRAb were collected from our hospital during January 2017 to June 2018,with 63 cases of CRAb and 45 cases of carbapenem-sensitive Acinetobacter baumannii(CSAb).Result:The univariate analysis showed that those factors were significantly correlated with lower respiratory infection in our hospital,such as serum albumin< 35 g/L,ICU hospitalization days before infection Ab≥3 days,brain trauma,mechanical ventilation,deep vein catheterization,combined use of antibiotics(P<0.05).The multivariate analysis showed that serum albumin<35 g/L,ICU hospitalization days before isolation of Ab≥3 days,deep vein catheterization,combined use of antibiotics were the independent risk factors of CRAb(P<0.05).Conclusion:Based on risk factors,the measures should be taken for high-risk hospitalized patients,so as to prevent and treat lower respiratory infection of CRAb reasonably.