摘要
目的探讨重症监护病房(ICU)鲍曼不动杆菌菌血症患者死亡的危险因素。方法收集分析了2011年1月至2015年12月在四川大学华西医院ICU住院的105例鲍曼不动杆菌菌血症患者的病例资料,根据14d预后将患者分为死亡组(36例)和存活组(69例),收集人口学、基础疾病、有创操作、临床特征、抗菌药物耐药性和治疗等资料。采用多因素Logistic回归分析确定14d死亡的独立危险因素。结果抗菌药物敏感性试验结果显示,多黏菌素B是最具抗鲍曼不动杆菌活性的抗菌药物(耐药率为0.0%),其后依次为替加环素(11.5%)、米诺环素(22.9%)和头孢哌酮/舒巴坦(23.6%)。105株菌株中98株(93.3%)是耐碳青霉烯鲍曼不动杆菌(CRAB)。慢性阻塞性肺疾病(COPD)、脑血管意外和机械通气在本研究中被确认为是14d死亡的独立危险因素。结论有创机械通气及包括COPD和脑血管意外在内的基础疾病与鲍曼不动杆菌菌血症患者病死率增加相关。
Objective To investigate risk factors for mortality in ICU patients with Acinetobacter baumannii bacteremia ,a retro‐spective study was performed .Methods Clinical data from 105 ICU patients with Acinetobacter baumannii bacteremia hospitalized in West China Hospital of Sichuan University from January 2011 to December 2015 were analyzed .According to the 14‐day progno‐sis after admission ,the patients were divided into non‐survivors group（n=36） and survivors group（n=69） .All the data on demo‐graphics ,underlying diseases ,invasive procedures ,clinical characteristics ,antimicrobial resistance ,and treatments were collected . Multivariate logistic regression analysis was used to explore independent risk factors for 14‐day mortality .Results The antimicro‐bial susceptibility tests showed that polymyxin B was the most active agent against the Acinetobacter baumannii isolates （resistance rate was 0 .0% ） ,followed by tigecycline （11 .5% ） ,minocycline（22 .9% ） ,and cefoperazone/sulbactam（23 .6% ） .98（93 .3% ） of the 105 blood culture isolates were carbapenem‐resistant Acinetobacter baumannii（CRAB） .In this study ,COPD ,cerebrovascular acci‐dent ,and mechanical ventilation were identified as independent risk factors for 14‐day mortality .Conclusion Invasive mechanical ventilation and underlying diseases including COPD and cerebrovascular accident were associated with increased mortality of pa‐tients with Acinetobacter baumannii bacteremia .
出处
《检验医学与临床》
CAS
2016年第23期3297-3300,3304,共5页
Laboratory Medicine and Clinic
关键词
鲍曼不动杆菌
菌血症
危险因素
病死率
重症监护病房
A cinetobacter baumannii
bacteriemia
risk factor
mortality
intensive care units
