摘要
目的:探讨儿童泛耐药鲍曼不动杆菌(PDRAb)医院获得性肺炎的危险因素及防治措施。方法:收集2011-2012年重庆医科大学附属儿童医院儿科重症监护室(PICU)收治的196例鲍曼不动杆菌(Ab)医院获得性肺炎患儿的临床资料,分为PDRAb组62例和非PDRAb(non-PDRAb)组134例,并对发生PDRAb的危险因素进行单因素分析和多元Logistic回归分析。结果:196例Ab医院获得性肺炎患儿中有62例感染PDRAb(31.63%)。Logistic多因素回归分析显示:感染Ab前机械通气时间(OR=3.25)、PICU住院时间(OR=5.91)、危重症评分<70分(OR=6.81)、胸部引流管留置时间(OR=4.62)、鼻饲喂养时间(OR=4.15)、吸痰次数(OR=4.48)、抗菌药物使用时间(OR=2.76)和使用碳青霉烯类抗生素(OR=5.37)是PDRAb医院获得性肺炎的独立危险因素。结论:病情严重、住院时间长、滥用抗菌药物和多种接触性操作易导致PDRAb医院感染性肺炎发生。加强无菌管理和合理使用抗菌药物是预防和控制PDRAb感染发生和蔓延的关键。
Objective： To study risk factors of hospital acquired pneumonia （HAP） caused by pandrug-resistant Acinetobacter Baumannii （PDRAb） , and to offer advice for the prevention and control of PDRAb infection. Methods： Clinical data of 196 cases of HAP caused by Acinetobacter Baumanii （Ab） from 2011 to 2012 in PICU of Children＇ s Hospital of Chongqing Medical University were analyzed. The risk factors of HAP caused by PDRAb were determined with univafiate and multivariatestepwise Logistic regression analysis. Results： Sixty-two （31.63%, 62/196） cases HAP children caused by PDRAb. Logistic regression analysis showed that ventilation duration （ OR = 3.25 ）, PICU length of stay （ OR = 5.91 ）, critical illness score below 70 （ OR = 6.81 ）, the time of intrathoracic drain （ OR = 4.62 ）, the frequency of nasogastric feeding （ OR = 4.15 ）, times of sputum suction （ OR = 4.48 ）, the course of antibiotic use （ OR = 2.76） and previous administration of carbapenems （ OR = 5.37 ） prior to PDRAh infection were the independent risk factors associated with HAP caused by PDRAb. Conclusions： Serious illness, long time hospitalization, antibiotics abuse and various contact operations were the risk factors of HAP caused by PDRAb. Strengthening the aseptic management and rational use of antibiotics were the key to the prevention and control of PDRAh infection.
出处
《儿科药学杂志》
CAS
2014年第6期40-43,共4页
Journal of Pediatric Pharmacy
关键词
鲍曼不动杆菌
危险因素
医院获得性肺炎
预防
Acinetobacter Baumannii
Risk factors
Hospital acquired pneumonia
Prevention
