摘要
目的了解重症监护病房(ICU)下呼吸道鲍氏不动杆菌院内感染的流行情况及危险因素,为下呼吸道鲍氏不动杆菌的院内感染控制提供依据。方法采用回顾性病例对照研究,以2011年ICU 103例下呼吸道鲍氏不动杆菌感染病例为研究对象,病例组为院内感染下呼吸道鲍氏不动杆菌的47例患者,同期分离的院外下呼吸道鲍氏不动杆菌的病例56例为对照组,分别采用单因素t检验、检验、多因素logistic回归分析危险因素及趋势分析剂量反应关系。结果 ICU下呼吸道鲍氏不动杆菌感染病例共103例,其中院内感染47例占45.63%;男性83例,女性20例,平均年龄(61.45±20.87)岁;单因素分析发现年龄、性别、抗菌药物联用、机械通气和中心静脉插管与下呼吸道鲍氏不动杆菌院内感染有关;经多因素logistic回归分析只有年龄(OR=1.051)和机械通气(OR=2.937)是下呼吸道鲍氏不动杆菌院内感染的重要危险因素;年龄、机械通气的天数均与ICU下呼吸道感染鲍氏不动杆菌之间存在剂量-反应关系。结论年龄越大、机械通气天数越长,发生下呼吸道鲍氏不动杆菌院内感染的风险越大,加强重点人群监测,规范各类侵入性操作,减少插管时间,将有利于减少下呼吸道鲍氏不动杆菌院内感染的发生。
OBJECTIVE To investigate the epidemiological characteristics and risk factors of Acinetobacter baummanii（AB） nosocomial infection in lower respiratory tract in intensive care unit（ICU）,in order to provide reference for infection control.METHODS A retrospective investigation method was used to collect the data of 103 patients with A.baummanii infections from Jan 2011 to Dec 2011 as the study objects,47 cases of A.baummanii nosocomial infections in lower respiratory tract were set as the case group,and 56 cases with A.baumannii isolated from the outside of the hospital were set as the control group.The univariate test,unconditional logistic regression and tendency chi-square test were employed to analyzed the relationship between dose and response.RESULTS Totally 103 patients were with respiratory tract infections caused by A.baumannii in ICU,among which there were 47（45.63%） cases with hospital-acquired infections,83 males and 20 females,the average age was（61.45±20.87） years.The univariate analysis showed that the age,sex,mechanical ventilation,combined use of antibiotics,and central venous indwelling catheterization were the related factors for lower respiratory tract infections caused by A.baumannii.The multivariate logistic regression analysis revealed that the age（OR=1.051） and mechanical ventilation（OR=2.937） were the significantly independent risk factors for the hospital-acquired respiratory tract infections.There was a dose-response relationship between the age,duration of mechanical ventilation,and the lower respiratory tract infections caused by A.baumannii in ICU.CONCLUSION The lower respiratory tract infections caused by A.baumanni are more prone to the patients with advanced age and the long duration of mechanical ventilation.It is conducive to reduce the incidence of lower respiratory tract infections to strengthen the monitoring of the key population,standardize the invasive operation,and shorten the duration of indwelling catheterization.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第21期4812-4814,共3页
Chinese Journal of Nosocomiology
关键词
下呼吸道
鲍氏不动杆菌
院内感染
危险因素
剂量-反应关系
Lower respiratory tract
Acinetobacter baummanii
Nosocomial infection
Risk factor
Dose-response relationship
