耐氨苄西林/舒巴坦鲍曼不动杆菌菌血症的危险因素及预后分析#br#

目的 探讨耐氨苄西林/舒巴坦鲍曼不动杆菌菌血症的危险因素及预后。方法 回顾分析2016年1月-2017年12月华西医院114例鲍曼不动杆菌菌血症患者的临床资料。结果 ①114例患者耐药63例(55.26%)，非耐药51例(44.74%)。②入住重症监护室(ICU)、机械通气、多肽暴露、复方制剂暴露、抗真菌药物暴露是耐药鲍曼感染的影响因素但均不是独立危险因素。③单因素分析显示影响预后的危险因素：住院时间、氨苄西林/舒巴坦耐药，机械通气，复方制剂暴露、抗真菌药物暴露、RBC、HGB、PLT。多因素分析：合并PLT减低是预后独立危险因素。结论 合并PLT减低是影响鲍曼不动杆菌菌血症患者预后的独立危险因素。

Analysis of the risk factors and prognosis of ampicillin-sulbactam-resistant Acinetobacter baumannii bacteremia

Objective To evaluate the risk factors and prognosis of ampicillin-sulbactam-resistant (CASR) Acinetobacter baumannii bacteremia. Methods Analysing the clinical characteristics of 114 patients with infections caused by A. baumannii in West China Hospital from Jan 2016 to Dec 2017 by retrospective analysis. Results ①Among 114 patients, there were 63 (55.26% ) patints with CASR A. baumannii and 51(44.74%) patients with non-CASR A. baumannii. ②ICU admission, mechanical ventilation, polypeptide, antibiotic compound, antifungal agents were the risk factors associated with CASR A. baumannii infection but not independent predictors. ③Univariate analysis revealed that the risk factors influencing the prognosis of A. baumannii infection were as follows: Length of hospital stay, drug resistance of ampicillin-sulbactam, mechanical ventilation, antifungal drug exposure, laboratory parameters such as RBC, HGB and PLT. Multivariate analysis suggested that bacteremia with thrombocytopenia was an independent risk factor for death of Acinetobacter baumannii. Conclusion Bacteremia with thrombocytopenia was an independent risk factor affecting the prognosis of A. baumannii