ICU患者鲍氏不动杆菌定植感染的调查分析

目的 调查ICU住院患者鲍氏不动杆菌(ABA)的定植、感染情况.方法 采用目标性监测方法,对2005年1月-2009年12月入住ICU的2864例患者发生ABA定植、感染的情况进行调查分析.结果 入住ICU前,3.9％的患者发生ABA定植,2.3％的患者感染,5.7％的患者定植或感染;入住ICU后16.9％的患者发生ABA定植,6.2％的患者感染,16.7％的患者定植或感染;患者入住ICU后定植率在第1周最高,为35.9％,第4周以后降至9.8％,差异有统计学意义(x2=192.35,P＜0.01);定植患者中发生ABA的感染率第1周为43.9％,第4周以后感染率100.0％,ABA定植患者感染率随住院时间延长而增加,差异有统计学意义(x2=166.73,P＜0.01);ABA定植或感染有明显的季节性,以冬季定植或感染率最高,差异有统计学意义(x2=22.39,P＜0.01);ABA定植与感染存在明显的相关性,定植是感染的危险因素.结论 ICU住院患者ABA定植、感染率有明显的特点,对医院感染存在较高的危险性,应根据ABA的定植或感染规律,采取必要的预防控制措施,避免ABA感染的暴发流行.

Investigation and analysis of colonization and infection of Acinetobacter baumanniiin ICU patients

OBJECTIVE To investigate Acinetobacter baumannii(ABA) colonizations and infections in ICU hospitalized patients.METHODS 2864 ICU hospitalized patients were determined for ABA colonizations and infections by using target monitoring method from Jan.2005 to Dec.2009.RESULTS Prior to ICU admitting,colonization of ABA was occurred in 3.9% patients,infection was observed in 2.3% patients and 5.7% patients were colonized or infected.Colonization of ABA was occurred in 16.9% patients,infection of ABA was occurred in 6.2% patients and colonization or infection was occurred in 16.7% patients of ICU admitted during the 5 year observing period.Colonization rate of ABA was up to 35.9% in ICU patients in the 1st week,and it dropped to 9.8% after 4 weeks.The difference was significant(χ2=192.35,P<0.01).Infection of ABA was 43.9% after 1 week of ICU treatment and 100% after 4 weeks of ICU treatment in colonization patient.The prevalence of ABA colonization in patients was increased and associated with hospitalization time.There was significant difference(χ2=166.73,P<0.01).ABA colonization or infection was significantly correlated with seasons.ABA colonization or infection rates were the highest during the winter.The difference was statistically significant(χ2=22.39,P<0.01).ABA colonization was correlated with infection rate and it is a risk factor for ABA infection of ICU patients.CONCLUSION Colonization or infection of ABA in ICU hospitalized patients was accompanied with distinctive features,and colonization of ABA was a higher risk of ABA infection in ICU patients.It was necessary to prevent and control the ABA colonization or infection so as to avoid the outbreak of ABA infections.