神经外科重症监护病房住院患者携带耐碳青霉烯鲍曼不动杆菌筛查结果报告

Active screening and colonization of acinetobacter carbapenem-resistant Acinetobacter baumannii in ICU neurosurgery patients and analysis of risk factors

目的了解医院神经外科重症监护病房(NICU)患者携带耐碳青霉烯鲍曼不动杆菌(CRAB)情况。方法采用整群抽样、前瞻性观察的研究方法,选择2018年12月—2019年2月入住某三级院NICU≥24 h的患者180例作为研究对象,于患者入住ICU 48 h内采集标本1次,然后进行CRAB主动筛查,每周1次,直至第4周,得出CRAB定植率,结合研究对象临床资料,分析CRAB定植/感染危险因素。结果该医院NICU患者CRAB定植率总平均为25.00%。患者的咽部、腋窝、腹股沟和直肠CRAB定植率依次分别为23.33%、13.89%、8.33%和5.00%。多因素分析显示,APACHE-Ⅱ评分≥22分、急诊入科、使用碳青霉烯类药物是NICU患者CRAB定植或感染的独立危险因素。结论NICU患者CRAB定植率较高,以主动筛查可有助于防控。

Objective To investigate the prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in patients in the neurosurgery intensive care unit(NICU)of a hospital.Methods From December 2018 to February 2019,a total of 180 patients admitted to a tertiary hospital NICU≥24 h were selected as the research objects by cluster sampling and prospective observation.Specimens were collected once within 48 h after admission to ICU,and then CRAB screening was performed once a week until the fourth week.The CRAB colonization rate was obtained,and the risk factors of CRAB colonization/infection were analyzed combined with the clinical data of the subjects.Results The average CRAB colonization rate of NICU patients was 25.00%.The rate of CRAB colonization in pharynx,axilla and groin was 23.33%,13.89%and 8.33%,respectively.The rate of CRAB colonization in rectum was 5.00%.Multivariate analysis showed that APACHE-Ⅱscore≥22,emergency admission and carbapenems use were independent risk factors for CRAB colonization or infection in NICU patients.Conclusion The CRAB colonization rate is high in NICU patients.Active screening is helpful for prevention and control of CRAB.