呼吸内科多重耐药鲍曼不动杆菌感染危险因素Logistic回归分析

Logistic regression analysis of risk factors for lower respiratory infections caused by multidrug-resistant Acinetobacter baumannii in the department of respiratory medicine

目的分析呼吸内科病房多重耐药鲍曼不动杆菌(MDRAB)下呼吸道感染患者的危险因素,为以后防治MDRAB感染提供依据。方法选取2016—2018年期间我院呼吸内科病房79例下呼吸道MDRAB感染患者作为多重耐药组,以同期感染无耐药鲍曼不动杆菌患者60例作为非多重耐药组,应用单因素分析及多因素Logistic回归分析MDRAB感染的可能危险因素。结果单因素Logistic回归分析结果显示:糖尿病、慢性阻塞性肺疾病(COPD)、气管插管、留置胃管、外周血白细胞计数、血清白蛋白、住院时间与下呼吸道MDRAB感染有关(P<0.05);多因素Logistics回归分析结果显示:气管插管(OR=3.362)、留置胃管(OR=3.143)是下呼吸道MDRAB感染的独立危险因素(P<0.05)。结论气管插管和留置胃管为我院呼吸内科患者下呼吸道MDRAB感染的独立危险因素,临床工作中应严格掌握以上2种侵入操作适应证,以减少MDRAB的感染。

Objective To explore the risk factors for lower respiratory infections caused by multidrug-resistant Acinetobacter baumannii(MDRAB)in the Department of Respiratory Medicine.Methods Seventy-nine cases of lower respiratory infections caused by MDRAB in our hospital 2016 to 2018 were chosen as the multidrug-resistant group.Additionally,60 cases of lower respiratory infections not caused by MDRAB were included as the control group.Univariate and multivariate logistic analyses were used to identify the risk factors for lower respiratory infections with MDRAB.Results Univariate analysis revealed that the risk factors for lower respiratory infections with MDRAB included diabetes,chronic obstructive pulmonary disease(COPD),endotracheal intubation,indwelling gastric tube,white blood cell count(WBC),serum albumin level and hospitalization duration(P<0.05).Subsequent multivariate logistic analysis showed that endotracheal intubation(OR=3.362)and the presence of an indwelling gastric tube(OR=3.143)were independent risk factors for lower respiratory infections with MDRAB.Conclusion Endotracheal intubation and the presence of an indwelling gastric tube were independent risk factors for lower respiratory infections with MDRAB.We should strictly limit the indications for these two invasive devices in clinical practice to reduce the incidence of infection of MDRAB.