耐碳青霉烯类鲍曼不动杆菌下呼吸道感染的危险因素研究
|
摘要
目的研究耐碳青霉烯类鲍曼不动杆菌(CRAB)下呼吸道感染的危险因素。方法通过回顾性分析方法,收集2014年1月1日至2017年9月30日期间上海市第一人民医院228例下呼吸道临床标本的检验结果,并进行单因素和多因素统计分析。结果从228例下呼吸道标本分离出CRAB 228株,其中确诊下呼吸道感染病例91例,占39. 9%;下呼吸道定植病例137例,占60. 1%。Logistic多因素回归分析结果显示,入院前6个月有住院史、入住ICU、使用氨基糖苷类抗菌药物等因素构成CRAB下呼吸道感染危险因素。结论住院患者下呼吸道感染耐碳青霉烯类抗菌药物鲍曼不动杆菌的危险因素主要是入院前半年内有住院史、入住ICU和使用氨基糖苷类抗菌药物。
Objective To find out the risk factors of Carbapenem-resistant Acinetobacter baumannii( CRAB) infection in low respiratory tract. Methods we retrospectively collected CRAB data of all the specimen from low respiratory tract among228 hospitalized patients between January 1 st,2014 and September 30 th,2017 and analyzed it with univariate analysis and logistic regression analysis. Results There were 228 CRAB detected from low respiratory tract specimens of 228 hospitalized patients,among which 91 were diagnosed as CRAB infection in low respiratory tract,accounting for 39. 9%; 137 were diagnosed as CRAB colonization,accounting for 60. 1%. The results of Logistic regression showed that the risk factors of CRAB infection in low respiratory tract were history of hospitalization within 6 months prior to admission,ICU admission,using of Aminoglycoside antibiotics. Conclusion The risk factors of CRAB infection in low respiratory tract are history of hospitalization within 6 months prior to admission,ICU admission,using of Aminoglycoside antibiotics.
Objective To find out the risk factors of Carbapenem-resistant Acinetobacter baumannii( CRAB) infection in low respiratory tract. Methods we retrospectively collected CRAB data of all the specimen from low respiratory tract among228 hospitalized patients between January 1 st,2014 and September 30 th,2017 and analyzed it with univariate analysis and logistic regression analysis. Results There were 228 CRAB detected from low respiratory tract specimens of 228 hospitalized patients,among which 91 were diagnosed as CRAB infection in low respiratory tract,accounting for 39. 9%; 137 were diagnosed as CRAB colonization,accounting for 60. 1%. The results of Logistic regression showed that the risk factors of CRAB infection in low respiratory tract were history of hospitalization within 6 months prior to admission,ICU admission,using of Aminoglycoside antibiotics. Conclusion The risk factors of CRAB infection in low respiratory tract are history of hospitalization within 6 months prior to admission,ICU admission,using of Aminoglycoside antibiotics.
引文
[1]Munoz-Price LS,Weinstein RA.Acinetobacter infection[J].NEngl J Med,2008,358(12):1271-1281.
[2]Munoz-Price LS,Weinstein RA.Acinetobacter infection-Reply[J].New Eng J Med,2008,358(26):2846-2847.
[3]陈佰义,何礼贤,胡必杰,等.中国鲍曼不动杆菌感染诊治与防控专家共识[J].中国医药科学,2012,2(8):3-8.
[4]胡付品,郭燕,朱德妹,等.2016年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2017,17(5):481-491.
[5]张辉,张小江,徐英春,等.2005-2014年CHINET不动杆菌属细菌耐药性监测[J].中国感染与化疗杂志,2016,16(4):429-436.
[6]刘又宁,曹彬,王辉,等.中国九城市成人医院获得性肺炎微生物学与临床特点调查[J].中华结核和呼吸杂志,2012,35(10):739-746.
[7]Dai XT,Sun FJ,Chen ZH,et al.The epidemiology and resistance mechanisms of Acinetobacter baumannii isolates from the respiratory department ICU of a hospital in China[J].Microb Drug Resist,2014,20(6):618-622.
[8]Yohei D,Ezenwa OO,Jennifer MAH,et al.Screening for Acinetobacter baumannii Colonization by Use of Sponges[J].J Clin Microbiol,2011,49(1):154-158.
[9]杨青,俞云松,林洁,等.2005-2014年CHINET呼吸道分离菌耐药性监测[J].中国感染与化疗杂志,2016,16(5):541-550.
[10]Liu P,Li X,Luo M,et al.Risk Factors for Carbapenem-Resistant Klebsiella pneumoniae Infection:A Meta-Analysis[J].Microb Drug Resist,2018,24(2):190-198.
[11]Falagas ME,Bliziotis IA,Siempos II.Attributable mortality of Acinetobacter baumannii infections in critically ill patients:a systematic review of matched cohort and case-control studies[J].Crit Care,2006,10(2):R48.
[12]王莉,周凤萍.ICU多重耐药鲍曼不动杆菌医院感染暴发流行病学调查[J].中国感染控制杂志,2013,12(2):113-116.
[13]Morgan DJ,Rogawski E,Thom KA,et al.Transfer of multidrug-resistant bacteria to healthcare workers'gloves and gowns after patient contact increases with environmental contamination[J].Crit Care Med,2012,40(4):1045-1051.
[14]Ardoino I,Zangirolami F,Iemmi D,et al.Risk factors and epidemiology of Acinetobacter baumannii infections in a university hospital in Northern Italy:A case-control study[J].Am J Infect Control,2016,44(12):1600-1605.
[2]Munoz-Price LS,Weinstein RA.Acinetobacter infection-Reply[J].New Eng J Med,2008,358(26):2846-2847.
[3]陈佰义,何礼贤,胡必杰,等.中国鲍曼不动杆菌感染诊治与防控专家共识[J].中国医药科学,2012,2(8):3-8.
[4]胡付品,郭燕,朱德妹,等.2016年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2017,17(5):481-491.
[5]张辉,张小江,徐英春,等.2005-2014年CHINET不动杆菌属细菌耐药性监测[J].中国感染与化疗杂志,2016,16(4):429-436.
[6]刘又宁,曹彬,王辉,等.中国九城市成人医院获得性肺炎微生物学与临床特点调查[J].中华结核和呼吸杂志,2012,35(10):739-746.
[7]Dai XT,Sun FJ,Chen ZH,et al.The epidemiology and resistance mechanisms of Acinetobacter baumannii isolates from the respiratory department ICU of a hospital in China[J].Microb Drug Resist,2014,20(6):618-622.
[8]Yohei D,Ezenwa OO,Jennifer MAH,et al.Screening for Acinetobacter baumannii Colonization by Use of Sponges[J].J Clin Microbiol,2011,49(1):154-158.
[9]杨青,俞云松,林洁,等.2005-2014年CHINET呼吸道分离菌耐药性监测[J].中国感染与化疗杂志,2016,16(5):541-550.
[10]Liu P,Li X,Luo M,et al.Risk Factors for Carbapenem-Resistant Klebsiella pneumoniae Infection:A Meta-Analysis[J].Microb Drug Resist,2018,24(2):190-198.
[11]Falagas ME,Bliziotis IA,Siempos II.Attributable mortality of Acinetobacter baumannii infections in critically ill patients:a systematic review of matched cohort and case-control studies[J].Crit Care,2006,10(2):R48.
[12]王莉,周凤萍.ICU多重耐药鲍曼不动杆菌医院感染暴发流行病学调查[J].中国感染控制杂志,2013,12(2):113-116.
[13]Morgan DJ,Rogawski E,Thom KA,et al.Transfer of multidrug-resistant bacteria to healthcare workers'gloves and gowns after patient contact increases with environmental contamination[J].Crit Care Med,2012,40(4):1045-1051.
[14]Ardoino I,Zangirolami F,Iemmi D,et al.Risk factors and epidemiology of Acinetobacter baumannii infections in a university hospital in Northern Italy:A case-control study[J].Am J Infect Control,2016,44(12):1600-1605.