摘要
目的探讨重症监护室发生泛耐药鲍氏不动杆菌(XDR-AB)感染的流行病学特征和危险因素。方法收集2014-2022年某三级教学医院重症监护室鲍氏不动杆菌(AB)感染患者的临床资料,分析其耐药模式,并拟合Logistic回归进行XDR-AB感染的危险因素分析。结果纳入2014-2022年在重症监护室就诊且被判定为AB感染的患者572例,判定为XDR-AB感染的患者481例(84.09%);重症监护室AB分离株除了妥布霉素和磺胺甲噁唑/甲氧苄啶外,AB菌株对多数常用抗菌药物均表现为高度耐药(79%以上);与非XDR-AB感染患者相比,住院时间(OR=1.004,95%CI:1.001~1.007)、使用呼吸机(OR=12.339,95%CI:6.790~22.787)和使用中心静脉管(OR=4.277,95%CI:2.180~8.345)是XDR-AB感染的独立危险因素。结论重症监护室AB感染患者的耐药形势严峻,需规范用药,加强医院感染控制,减少患者住院时间。
OBJECTIVE To explore the epidemiological characteristics and risk factors for extensively drug-resistant Acinetobacter baumannii(XDR-AB)infection in intensive care unit.METHODS The clinical data were collected from the patients with A.baumannii infection who were treated in intensive care unit of a tertiary teaching hospital from 2014 to 2022,the drug resistance modes were analyzed,and logistic regression analysis was performed for the risk factors for the XDR-AB infection.RESULTS From 2014 to 2022,totally 572 patients were treated in intensive care unit and were diagnosed with A.baumannii infection,481(84.09%)of whom were determined as the XDR-AB infection.The drug resistance rates to most of the commonly used antibiotics were more than 79%.As compared with the patients with non-XDR-AB infection,length of hospital stay(OR=1.004,95%CI:1.001-1.007),use of ventilator(OR=12.339,95%CI:6.790-22.787)and use of central venous catheter(OR=4.277,95%CI;2.180-8.345)were the independent risk factors for the XDR-AB infection.CONCLUSION The intensive care unit patients with A.baumannii infection show severe situation of drug resistance.It is necessary to reasonably use antibiotics,strengthen the control of nosocomial infection and shorten the length of hospital stay.
作者
刘晓丽
杨姗姗
杜明梅
于正浩
姚宏武
白艳玲
刘运喜
LIU Xiao-li;YANG Shan-shan;DU Ming-mei;YU Zheng-hao;YAO Hong-wu;BAI Yan-ling;LIU Yun-xi(Chinese PLA Medical School,Beijing 100853,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第10期1441-1446,共6页
Chinese Journal of Nosocomiology
基金
国家重点研发计划(2017YFC0806308)
生物安全能力建设计划(145AHQ080020005X)
“感·动中国”医疗机构感染预防与控制科研项目(GY2023022-A)。
关键词
泛耐药鲍氏不动杆菌
医院感染
重症监护室
流行病学
危险因素
Extensively drug-resistant Acinetobacter baumanni
Nosocomial infection
Intensive care unit
Epidemiology
Risk factor
