摘要
目的了解入住重症监护病房(ICU)患者耐碳青霉烯类鲍曼不动杆菌(CRAB)感染的危险因素。方法选取2017-2018年上海市某三甲医院ICU患者738例,采用病例对照研究,病例组为入住ICU 48 h后感染CRAB患者,对照组为入住ICU 48 h后无CRAB感染者,进行单因素和多因素Logistic分析。结果 738例患者中,62例患者发生CRAB感染,感染率为8. 40%。CRAB感染以呼吸机相关性肺炎为主,占54. 84%;其次为下呼吸道感染(33. 87%)、导管相关性血流感染(4. 84%)、菌血症(1. 61%)、导尿管相关尿路感染(1. 61%)、泌尿道感染(1. 61%)和器官腔隙感染(1. 61%);多因素Logistic回归分析结果显示ICU患者发生CRAB感染的独立危险因素有GCS <8分、白蛋白含量<25 g/L、机械通气> 7 d、CRAB感染前抗菌药物使用种数两联及以上。结论 CRAB是ICU内检出率很高的条件致病菌,早期干预危险因素有助于减少ICU内CRAB的发生率。
Objective To investigate the risk factors for carbapenem-resistant Acinetobacter baumannii(CRAB)infection in patients of the intensive care unit(ICU).Methods A total of 738 ICU patients from a level tertiary hospital in Shanghai from 2017 to 2018 were enrolled,and case-control study was conducted.The patients infected with CRAB after ICU admission 48 h were the case group,and those without CRAB infection after ICU admission 48 h were the control group.Univariate and multivariate Logistic analysis were conducted.Results Among 738 patients,62 had CRAB infection and the infection rate was 8.40%.CRAB infection was mainly ventilator-associated pneumonia(54.84%),followed by lower respiratory tract infection(33.87%),catheter-related bloodstream infection(4.84%),bacteremia(1.61%),catheterization associated urinary tract infection(1.61%),urinary tract infection(1.61%),organ cavity infection(1.61%);multivariate Logistic regression analysis showed that independent risk factors for CRAB infection in ICU patients were GCS<8,albumin cotent<25 g/L,mechanical ventilation>7 d,using two or more antibacterial drugs before CRAB infection.Conclusion CRAB is a conditional pathogen with high detection rate in ICU.Early intervention for the risk factors can help reduce the incidence of CRAB in ICU.
作者
梁继仁
杨惠英
刘银梅
钱秀芳
余红
LIANG Ji-ren;YANG Hui-ying;LIU Yin-mei;QIAN Xiu-fang;YU Hong(Shanghai Tenth People's Hospital,Shanghai 200072,China)
出处
《中国消毒学杂志》
CAS
2019年第9期668-670,共3页
Chinese Journal of Disinfection
关键词
重症监护病房
耐碳青霉烯类鲍曼不动杆菌
危险因素
医院感染
intensive care unit
carbapenem-resistant Acinetobacter baumannii
risk factor
nosocomial infection
