某院耐碳青霉烯类鲍曼不动杆菌感染的危险因素分析

目的 探讨影响耐碳青霉烯类鲍曼不动杆菌(carbapenem resistant Acinetobacter baumannii,CRAB)感染的危险因素,为感染防控和临床治疗提供依据.方法 选取海口市第三人民医院2017年1月-2019年12月鲍曼不动杆菌(Acinetobacter baumannii,AB)感染患...

Risk factors of carbapenem-resistant Acinetobacter baumannii infection in a hospital

  Objective  To explore and analyse risk factors affecting carbapenem-resistant Acinetobacter baumannii (CRAB) infection in our hospital and to provide evidence for infection prevention and control and clinical treatment.   Methods  From January 2017 to December 2019, 572 patients with Acinetobacter baumannii (AB) infection in our hospital were selected as the research objects. According to the results of drug sensitivity, they were divided into the CRAB group (387 cases) and carbapenem-sensitive Acinetobacter baumannii (CSAB) group (185 cases). The clinical data of both groups were collected. Single-factor and multivariate logistic regression were used to analyse the risk factors of CRAB infection.   Results  Amongst 572 patients with AB infection, the CRAB infection rate was 67.66% (387/572). Univariate analysis showed that history of diabetes, chronic lung disease, use of incision drainage tube, bronchoscopy, use of adrenal glucocorticoids, use of tigecycline, use of carbapenem antibiotics and use β-lactamase inhibitor antibiotics of CRAB group and CSAB group were statistically significant (all P < 0.05). Multivariate logistic regression analysis showed that diabetes history (OR=2.884, 95% CI: 1.105-7.206), use of incision drainage tube (OR=5.106, 95% CI: 1.834-14.270), bronchoscopy (OR=4.497, 95% CI: 1.704-12.365), use of tigecycline (OR=3.514, 95% CI: 1.482-8.945) and use of carbapenem antibiotics (OR=5.282, 95% CI: 2.146-15.308) were risk factors for CRAB infection (all P < 0.05).   Conclusion  Many risk factors are associated with CRAB infection. The management of patients with CRAB infection should be strengthened, and antibiotics should be used rationally to reduce the CRAB infection rate.